PEMERINTAH KABUPATEN BUTON SELATAN

DINAS PENDIDIKAN
Jalan Gajah MadaNomor 34 BataugaKodePos : 93752 Email : dikdasbusel@gmail.com
Telpon (040....) ...........Faksmile (040...) ........

BIODATA PESERTA
KEGIATAN PELATIHAN ASESMEN NASIONAL BERBASIS KOMPUTER ( ANBK )
JENJANG SEKOLAH MENENGAH PERTAMA TAHUN 2022

1. Nama : .....................................................................................

2 NIP : .....................................................................................

3. Pangkat/ Gol. : .....................................................................................

4. Jabatan : .....................................................................................

5. Tempat/Tanggal Lahir :.....................................................................................

6. Jenis Kelamin :.....................................................................................

7. Pendidikan Terakhir :.....................................................................................

8. Unit Kerja : .....................................................................................

9. Alamat Kerja : ......................................................................................

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10. Alamat Rumah : ......................................................................................

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11. No. HP : .......................................................................................

13. Email : .......................................................................................

Batauga , 09 September 2022

Peserta,

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NIP. .........................................