Di ..................................................................
TAHUN PELAJARAN 2022 / 2023
NAMA : ...........................................................................
KELAS : .........................................
FOTO
UKURAN 4 X 6 CM
Nama : .....................................................................................................
Kelas : .....................................................................................................
Tempat, Tanggal Lahir : ....................................................................................................
Kompetensi Keahlian : ....................................................................................................
Alamat : ....................................................................................................
Nomor Telepon : ....................................................................................................
Email : ....................................................................................................
Jakarta, .....................................................
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Data Kegiatan Selama Praktik/Magang
Tanda Tangan
No Hari / Tanggal Kegiatan Yang Dilakukan
Pembimbing
KOMPONEN PENILAIAN SISWA PRAKTIK/MAGANG
Nama Siswa :
Jurusan :
Nama Instansi/DUDI :
Lama Praktek :
Alamat Instansi/DUDI :
Jakarta, ........................................
Pembimbing Praktik/Magang,
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DOKUMENTASI KEGIATAN PRAKTIK