FORMULIR PENDAFTARAN
PENGURUS OSIS (PERIODE 2023-2024)
SMK MUTIARA TERPADU PALABUHANRATU
Nama : _________________________________________________________
Tempat, Tanggal Lahir : _________________________________________________________
Alamat : _________________________________________________________
Kelas : _________________________________________________________
Nama Orang Tua : _________________________________________________________
No. Telp/Hp. : _________________________________________________________
Motto Hidup : _________________________________________________________
Email : _________________________________________________________
Pengalaman Berorganisasi : ________________________Jabatan___________________________
Visi : _________________________________________________________
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Misi : _________________________________________________________
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Sekbid/Divisi :
KTYME (Ketuhanan Yang Maha Esa) KBPL (Kepribadian & Budi Pekerti Luhur)
KBBN (Kesatuan Berbangsa & Bernegara) KJDK (Kebugaran Jasmani & Kesehatan)
KITS (Komunikasi, Informasi & Teknologi Siswa) AKKS (Apresiasi Kreatif & Kesenian Siswa)
*Centang kolom sekbid/divisi yang diinginkan
Alasannya : _______________________________________________________________
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Palabuhanratu, 25 Juli 2023
Orang Tua Siswa Calon OSIS
Mengetahui,
Pembina OSIS