PENERIMAAN PESERTA DIDIK BARU ( PPDB )

TAHUN AJARAN 2022 – 2023

TK PARENTAS DESA BERENG RAMBANG
IDENTITAS

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

2. Jenis Kelamin :.............................................................................................................................................
3. NIK :.............................................................................................................................................
4. Tempat/Tgl Lahir :.............................................................................................................................................
5. Agama :.............................................................................................................................................
6. Kewarganegaraan :.............................................................................................................................................
7. Alamat Lengkap :.............................................................................................................................................
:.............................................................................................................................................
8. Tinggal Bersama :.............................................................................................................................................
9. Anak Ke :.............................................................................................................................................
10. Usia :.............................................................................................................................................
11. NO HP :.............................................................................................................................................
ORANG TUA

1. Nama Ayah :.............................................................................................................................................

NIK :.............................................................................................................................................
Tahun Lahir :.............................................................................................................................................
Pendidikan :.............................................................................................................................................
Pekerjaan :.............................................................................................................................................
2. Nama Ibu :.............................................................................................................................................
NIK :.............................................................................................................................................
Tahun Lahir :.............................................................................................................................................
Pendidikan :.............................................................................................................................................
Pekerjaan :.............................................................................................................................................
PERIODIK

1. Tinggi Badan :.............................................................................................................................................

2. Berat Badan :.............................................................................................................................................
3. Jarak Tempuh :.............................................................................................................................................
4. Jumlah saudara :.............................................................................................................................................
REGISTER

1. Jenis Pendaftaran : A. Siswa Baru B. Pindahan c. Sekolah Lagi

2. Tgl masuk Sekolah :.............................................................................................................................................

3. No Induk Siswa :.............................................................................................................................................

4. Masuk Rombel : A / B (A . 4-5 tahun B. 5-6 tahun)

Orang Tua Siswa Orang Tua Siswa

Foto 3 x 4

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