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  • Isian Usul PTK

    Diunggah oleh

    Azzep Frondoza
    4 tayangan1 halaman

    Judul Asli

    ISIAN_USUL_PTK

    Hak Cipta

    © © All Rights Reserved

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    © All Rights Reserved
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    4 tayangan1 halaman

    Isian Usul PTK

    Diunggah oleh

    Azzep Frondoza

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai DOCX, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    IDENTITAS

    NIK : ....................................................................................................
    Nama : ....................................................................................................
    Nama sesuai dengan KK/KTP : ....................................................................................................
    Tempat Lahir : ....................................................................................................
    Tanggal Lahir : ....................................................................................................
    Jenis Kelamin : ....................................................................................................
    Nama Ibu Kandung : ....................................................................................................
    (sesuai dengan KK/KTP)
    Agama : ....................................................................................................
    Status Perkawinan : ....................................................................................................
    Email : ....................................................................................................

    DOMISILI ( SESUAI KTP YANG BERLAKU)


    Kabupaten / Kota : ....................................................................................................
    Kecamatan : ....................................................................................................
    Alamat : ....................................................................................................
    Desa Kelurahan : ....................................................................................................
    (Desa Kelurahan tidak boleh kosong)
    Kode Pos : ....................................................................................................

    KEPEGAWAIAN
    Status Kepegawaian : ....................................................................................................
    NIP : ....................................................................................................
    Jenis PTK : ....................................................................................................
    Lembaga Pengangkat : ....................................................................................................
    No SK Pengangkatan : ....................................................................................................
    Tmt Pengangkatan : ....................................................................................................
    Sumber Gaji : ....................................................................................................
    Sudah Lisensi Kepala Sekolah : ....................................................................................................

    PENUGASAN
    Wilayah Kab/kota : ....................................................................................................
    Sekolah : ....................................................................................................
    Nomor Surat Tugas : ....................................................................................................
    Tanggal Surat Tugas : ....................................................................................................
    TMT Tugas : ....................................................................................................

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