IDENTITSAS SISWA

SMK NEGERI 7 SEMARANG

1. Nama :........................................................................................
2. NIS :........................................................................................
3. Kelas :........................................................................................
4. Kompetensi Keahlian :........................................................................................
5. Tempat, Tanggal lahir :........................................................................................
6. Alamat Rumah :........................................................................................
:........................................................................................
Telepon/ HP :........................................................................................
.................................................................................................................
E-mail :........................................................................................

7. Golongan Darah :........................................................................................

8. Nama Orang Tua/ Wali :........................................................................................
9. Alamat Orang Tua/ Wali :........................................................................................
:........................................................................................
Telepon/ HP :........................................................................................

10. Catatan tentang Kesehatan Siswa :

.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
11. Nama Guru Pembimbing :........................................................................................
12. NIP Guru Pembimbing :........................................................................................

..………., ….……………………..
Peserta Praktik Kerja Lapangan,

…………………………………….
 IDENTITAS INDUSTRI / INSTANSI
TEMPAT PKL

1. Nama Industri / Instansi : .....................................................................................

2. Bidang Usaha : .....................................................................................
3. Alamat : .....................................................................................
: .....................................................................................
Telepon : .....................................................................................
Fax : .....................................................................................
E-mail : .....................................................................................
Website : .....................................................................................
4. Nama Pemimpin : .....................................................................................
5. Nama Pemb. Industri : .....................................................................................
6. Nama Instruktur : 1 ..................................................................................
: 2 ..................................................................................
: 3 ..................................................................................

PELAKSANAAN JAM MASUK, ISTIRAHAT, DAN PULANG

PRAKTIK KERJA LAPANGAN (PKL)

Hari Jam Masuk Jam Istirahat Jam Pulang

Minggu
Senin
Selasa
Rabu
Kamis
Jumat
Sabtu

……………... , ……………………..
Instruktur,

…………………………………….
Nama dan tanda tangan
 SCHEDULE KEGIATAN PKL

Periode :
Jumlah Minggu :
Tgl. Mulai :
Tgl. Selesai :

Mgg ke-
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Kegiatan

Orientasi/
Observasi

Managemen

Praktik
Kerja
Lapangan

Penyusunan
Laporan

*) Diberi arsir schedule kegiatan PKL sesuai kesepakatan dengan pembimbing industri.

Catatan :
Pelaksanaan kegiatan PKL tersebut secara teknis dapat disesuaikan dengan situasi dan kondisi
setempat.
 DAFTAR HADIR
PESERTA PKL SMK NEGERI 7 SEMARANG
TAHUN PELAJARAN 2022/2023

NAMA : ..........................................................................................
NIS : ..........................................................................................
KELAS : ..........................................................................................
KOMPETENSI KEAHLIAN : ..........................................................................................
TEMPAT PKL : ..........................................................................................
PERIODE : ..........................................................................................

NO TAHUN 2022 TAHUN 2023

TGL
JUL AGT SEP OKT NOV DES JAN FEB MAR APR MEI JUN
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
Sakit
Ijin
KET
Alpa
Hadir
Paraf Instr

………………. , ………………..
Pembimbing / Instruktur Industri,

……………………………………