*KriteriaKetuntasanMinimal
PENGEMBANG
ANDIRI
Nilai
No
BENTUKKEGIATAN
A B
1
2
3
NamaMadrasah :........................... Kelas :..
NISN :...........................
PERILAKU
......................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
PERILAKU/KEPERIBADIAN KETIDAKHADIRAN/ABSENSI
No Aspek Keterangan No Alasan J
1 1
2 2
3 3
Menge
WaliKelas KepalaMadrasah
tahui
Orang Tua
/Wali
(............................................) (............................................) (................................