PEMERINTAH KABUPATEN JOMBANG

DINAS PENDIDIKAN DAN KEBUDAYAAN

SDN BONGKOT
KECAMATAN PETERONGAN KABUPATEN JOMBANG
Dsn Sentulan,Desa Bongkot Peterongan - Jombang

Rekomendasi Kepala Sekolah

Yang bertandatangan dibawah ini:

Nama : ISTIKOMAH,S.Pd.
NIP : 19640616 1994032005
Jabatan : Kepala Sekolah
Unit Kerja : SDN Bongkot
Alamat : Dsn Sentulan Desa Bongkot Peterongan

Memberikan rekomendasi kepada:

Nama : MULYONO,S.Pd
NIP : 19690723 1995 03 1 001
Jabatan : Guru
Unit Kerja : SDN Bongkot
Alamat : Dsn Sentulan Desa Bongkot Peterongan

Berapa lama Saudara mengenal pelamar?

......................................................................................................................................................

Petunjuk Pengisian:
Berilah tanda cek (√) dalam kotak didepan skala penilaian pada setiap kompetensi
1. KOMPETENSI PEDAGOGIK

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
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2. KOMPETENSI KEPRIBADIAN

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
.......................................................................................................................................................
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3. KOMPETENSI SOSIAL

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
.......................................................................................................................................................
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4. KOMPETENSI PROFESIONAL

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar ini yang mendukung
penilaian Saudara:
.......................................................................................................................................................
.......................................................................................................................................................
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.......................................................................................................................................................
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PENGEMBANGAN KEPROFESIAN
Silahkan berikan komentar tentang pengembangan keprofesian pelamar saat ini yang
dianggap berkontribusi pada peningkatan kegiatan-kegiatan profesionalan pelamar :
.......................................................................................................................................................
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RANGKUMAN REKOMENDASI

Berdasarkan Penilaian Profesional saya, pelamar telah menunjukan hasil yang

Kurang Memuaskan Memuaskan Sangat memuaskan

dalam hal pengembangan kompetensi untuk melaksanakan tugas tambahan sebagai kepala
sekolah.

Demikian rekomendasi ini saya buat dengan sebenar-benarnya tanpa ada tekanan dari pihak
manapun.

.Peteronga, 17 September 2021

Kepala Sekolah Bongkot

ISTIKOMAH,S.Pd.
NIP.19560918 198112 1 001
 PEMERINTAH KABUPATEN JOMBANG
DINAS PENDIDIKAN
UPTD PENDIDIKAN KECAMATAN PETERONGAN
Jl. Brawijaya No. 75 Telp.(0321)860962 Peterongan-Jombang (61481)

Rekomendasi Pengawas Sekolah

Yang bertandatangan dibawah ini:

Nama : Hj. AZ UHUD S.Ag.M.PdI
NIP : 19621116 198504 2 006
Jabatan : Pengawas Sekolah
Unit Kerja : UPTD Kecamatan Peterongan
Alamat : Jl. Brawijaya 75 – Peterongan

Memberikan rekomendasi kepada:

Nama : LULUK JULIATI,S.PD SD
NIP : 19660723 199403 2 005
Jabatan : Guru
Unit Kerja : SDN Peterongan 1
Alamat : Jl. Brawijaya 77 – Peterongan

Berapa lama Saudara mengenal pelamar?

.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................................................

Petunjuk Pengisian:
Berilah tanda cek (√) dalam kotak didepan skala penilaian pada setiap kompetensi
1. KOMPETENSI KEPRIBADIAN

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................................................
......................................................................................................................................................
2. KOMPETENSI MANAJERIAL

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
.......................................................................................................................................................
.......................................................................................................................................................
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.......................................................................................................................................................
.......................................................................................................................................................
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3. KOMPETENSI KEWIRAUSAHAAN

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar yang mendukung

penilaian Saudara:
.......................................................................................................................................................
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.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................

4. KOMPETENSI SUPERVISI

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar ini yang mendukung
penilaian Saudara:
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................................................

5. KOMPETENSI SOSIAL

Kurang Memuaskan Memuaskan Sangat memuaskan

Tuliskan hasil pengamatan Saudara perihal kegiatan-kegiatan pelamar ini yang mendukung
penilaian Saudara:
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................................................

PENGEMBANGAN KEPROFESIAN
Silahkan berikan komentar tentang pengembangan keprofesian pelamar saat ini yang
dianggap berkontribusi pada peningkatan kegiatan-kegiatan profesionalan pelamar :
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
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.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................

RANGKUMAN REKOMENDASI

Berdasarkan Penilaian Profesional saya, pelamar telah menunjukan hasil yang

Kurang Memuaskan Memuaskan Sangat memuaskan

dalam hal pengembangan kompetensi untuk melaksanakan tugas tambahan sebagai kepala
sekolah.

Demikian rekomendasi ini saya buat dengan sebenar-benarnya tanpa ada tekanan dari pihak
manapun.

Peterongan, 17 September 20.13

Pengawas Sekolah

.Hj. UZ.UHUD,S.Ag. M.MPd.I

Nip. 19621116 198504 2 006