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BIODATA PESERTA GURU

KEGIATAN PENGELOLAAN PENDIDIKAN DASAR JUMLAH PENDIDIK DAN TENAGA


KEPENDIDIKAN YANG MENDAPATKAN FASILITASI KENAIKAN PANGKAT/GOLONGAN,
PEMBERIAN PROMOSI, PENINGKATAN KOMPETENSI DAN KUALIFIKASI
KOTA TASIKMALAYA TAHUN 2023

1. Nama (lengkap dengan gelar) : ..........................................................................

2. Tempat/Tanggal lahir : ......................................./..................................

3. Agama : ..........................................................................

4. Jenis kelamin : ..........................................................................

5. Pangkat/Gol. Ruang : ......................................./..................................

6. NIP : ......................................./..................................

7. Jabatan : ..........................................................................

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

9. Pendidikan terakhir : ..........................................................................

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

10. Alamat Sekolah : ..........................................................................

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

Telp. Sekolah : ..........................................................................

11. Alamat Rumah : ..........................................................................

: ..........................................................................

Telp. Rumah : (.........)........................HP..................................

Alamat Email : …………………………………………………

Tasikmalaya, ............................. 2023

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

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