FORMAT SUPERVISI mid SEMESTER ganjil

TAHUN PELAJARN 2022 / 2023

1. NAMA SEKOLAH : ..............................................................

2. ALAMAT SEKOLAH : .............................................................

3. KELAS : ..............................................................

4. JURUSAN : ..............................................................

5. MATA PELAJARAN : ...............................................................

6. JUMLAH SISWA : ...............................................................

A. HADIR : ..... SISWA

B. TIDAK HADIR : ...... SISWA

7. NAMA PENGAWAS TIDAK HADIR :

A. ..............................................................

B. ..............................................................

8. KELENGKAPAN ADMINISTRASI :

A. BERITA ACARA : ADA / TIDAK

B. ABSENSI SISWA : ADA / TIDAK

C. ABSEN PENGAWAS : ADA / TIDAK

9. KETERANGAN : ..............................................................

10. CATATAN :

.......................................................................................................

.......................................................................................................

Ambulu , ...................................

Petugas ,

( .......................................... )