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PONDOK PESANTREN

AN – NASHR
Kp. Suniasari Rt. 02 Rw. 04 Ds. Mekarjaya Kec. Tarogong Kaler Kab. Garut

FORMULIR PESANTREN

I.Santri

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


Nama Panggilan :.....................................................................................................................................
NIK :………………………………………………………………………………………………
NISN :………………………………………………………………………………………………
Alamat Lengkap :.....................................................................................................................................
......................................................................................................................................
Tempat Tanggal Lahir :....................................................................................................................................
No Hp/WA :....................................................................................................................................

II. Orang Tua/Wali Santri


Nama Ayah :............................................................................................................................................
NIK :…………………………………………………………………………………………………..
Pekerjaan :............................................................................................................................................
No Hp/ WA :............................................................................................................................................
Nama Ibu :............................................................................................................................................
NIK :…………………………………………………………………………………………………..
Pekerjaan :............................................................................................................................................
No Hp/ WA :............................................................................................................................................

Catatan :

 Data Formulir harus di isi semua!;


 Formulir wajib dikembalikan/dikumpulkan ke pihak pengurus pesantren
 Nomor Hp/WA Orang Tua Santri harus WAJIB di Isi

Garut, 16 Juli 2023


Orang Tua/ Wali Santri

…………………………………...

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