Formulir Pendaftaran Lomba Hari Ibu

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

2. Tempat Lahir :..........................................................................................

3. Tanggal Lahir :..........................................................................................

4. Asal Sekolah :..........................................................................................

5. Alamat Rumah :..........................................................................................

6. Nomer WA Orang Tua/ :..........................................................................................

Pendamping

7. Pilihan Lomba Yang Di ikuti :

□ Mewarnai
□ Tartil
□ Menyanyi

Mengetahui Jombang, ….. Desember 2022

Panitia Lomba Pesserta

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