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ORGANISASI SISWA INTRA SEKOLAH

SMA NEGERI 2 SURABAYA


Jl. Wijaya Kusuma No. 48 Telp. (031) 5345972 Fax. 5468564
Website : www.sman2-sby.sch.id Surabaya

FORMULIR PENDAFTARAN
CALON PENGURUS OSIS/MPK
SMA NEGERI 2 SURABAYA MASA BAKTI 2023-2024

A. BIODATA PRIBADI
Nama lengkap : ................................................................................................
Tempat, tanggal lahir : ................................................................................................
Alamat : ................................................................................................ Foto
3x4
Kelas / absen : ................................................................................................
Nomor telepon : ................................................................................................
ID Line : ................................................................................................
B. BIODATA ORANG TUA / WALI
Nama lengkap : ................................................................................................
Nomor telepon : ................................................................................................
Pekerjaan : ................................................................................................
C. VISI & MISI
Visi : ................................................................................................
Misi : 1. ............................................................................................
2. ............................................................................................

3. ............................................................................................

Dengan ini menyatakan bahwa saya (bersedia/tidak bersedia) untuk mengikuti Pendaftaran
Calon Pengurus OSIS/MPK SMA Negeri 2 Surabaya Masa Bakti 2023-2024.

Surabaya, 2023
Siswa Orang Tua / Wali

Materai 10.000

(...................................) (...............................................)

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