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OLIMPIADE SISWA NASIONAL (OSN)

TINGKAT KECAMATAN CIKALONGKULON 2019

BIODATA PESERTA

Mata Lomba : MATEMATIKA

Jenjang : SD

Kecamatan : ..........................................................................

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

2. NIS/ NISN : ..........................................................................

3. Jenis Kelamin : ..........................................................................

4. Tempat/Tgl. Lahir : ..........................................................................

5. Kelas : ..........................................................................

6. Agama : ..........................................................................

7. Nama Sekolah : ..........................................................................

8. Alamat Rumah : ..........................................................................

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

Cianjur, ..........................
Kepala Sekolah,

(.......................................)
NIP
OLIMPIADE SISWA NASIONAL (OSN)
TINGKAT KECAMATAN CIKALONGKULON 2019

BIODATA PESERTA

Mata Lomba : ILMU PENGETAHUAN ALAM (IPA)

Jenjang : SD

Kecamatan : ..........................................................................

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

2. NIS/ NISN : ..........................................................................

3. Jenis Kelamin : ..........................................................................

4. Tempat/Tgl. Lahir : ..........................................................................

5. Kelas : ..........................................................................

6. Agama : ..........................................................................

7. Nama Sekolah : ..........................................................................

8. Alamat Rumah : ..........................................................................

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

Cianjur, ..........................
Kepala Sekolah,

(.......................................)
NIP

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