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PANITIA (FESPI’4) FESTIVAL SENI PELAJAR ISLAM

TINGGKAT SMP/MTS & SMA/SMK/MA SE-JAWA TIMUR

SMK NEGERI 6 SURABAYA


JL. Margorejo No.76, Wonocolo Telp. (031) 8438267 Fax. (031) 8435777 email : smkn6s@yahoo.com

FORMULIR PENDAFTARAN PESERTA FESPI’4 (Festival Seni Pelajar Islam ke-4)


TINGKAT PELAJAR MTs/SMP & SMA/SMK/MA SE-JAWA TIMUR

I. NAMA GROUP : ..................................................................................................

II. ASAL SEKOLAH : ..................................................................................................

III. NO. TELP : ..................................................................................................

IV. LAGU PILIHAN : ..................................................................................................

V. NAMA PESERTA :

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PANITIA (FESPI’4) FESTIVAL SENI PELAJAR ISLAM
TINGGKAT SMP/MTS & SMA/SMK/MA SE-JAWA TIMUR

SMK NEGERI 6 SURABAYA


JL. Margorejo No.76, Wonocolo Telp. (031) 8438267 Fax. (031) 8435777 email : smkn6s@yahoo.com

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PANITIA (FESPI’4) FESTIVAL SENI PELAJAR ISLAM
TINGGKAT SMP/MTS & SMA/SMK/MA SE-JAWA TIMUR

SMK NEGERI 6 SURABAYA


JL. Margorejo No.76, Wonocolo Telp. (031) 8438267 Fax. (031) 8435777 email : smkn6s@yahoo.com

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SURABAYA, ................................................. 2022


PIMPINAN GROUP

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PANITIA (FESPI’4) FESTIVAL SENI PELAJAR ISLAM
TINGGKAT SMP/MTS & SMA/SMK/MA SE-JAWA TIMUR

SMK NEGERI 6 SURABAYA


JL. Margorejo No.76, Wonocolo Telp. (031) 8438267 Fax. (031) 8435777 email : smkn6s@yahoo.com

CATATAN :
 Diisi dengan huruf kapital
 Dilampiri dengan fotocopy kartu pelajar dan surat rekomendasi

POTONG DISINI
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TANDA BUKTI PELUNASAN PENDAFTARAN
FESPI’4 (Festival Seni Pelajar Islam ke 4) MTs/SMP & SMA/SMK/MA SE JAWA TIMUR

 TELAH DITERIMA DARI GROUP :


 ASAL SEKOLAH :
 UANG BESARAN : A. Rp 120.000 B. Rp 135.000
 UNTUK PEMBAYARAN :
 PESERTA LOMBA KATEGORI : A. MTs/SMP B. SMA/SMK/MA

SURABAYA, ....................... 2022

Panitia Penerima

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