Data Orangtua
Nama Orang Tua
A. Ayah :..................................................................................................
B. Ibu :..................................................................................................
Alamat Orang Tua :..................................................................................................
..................................................................................................
No Hp Ayah/Ibu :..................................................................................................
Pekerjaan Orang Tua
A. Ayah :..................................................................................................
B. Ibu :..................................................................................................
Pangkalan Susu,..................................
Kepala Sekolah Rumah Qur’an
Al-Amin Pangkalan Susu
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11
12.
13.
14.
15.
16.
17.
18.
Total
Nilai rata-rata :