YAYASAN TARBIYAH PERTI JAMBI

Nomor AHU-0002818.AH.01.04.2017

MTsS. TARBIYAH ISLAMIYAH

KECAMATAN JELUTUNG
TERAKREDITASI “B”
NPSN : 69754821 - NSM : 121215710026
Jl. Dr. Sumbiyono No. 02 RT 11 Kel. Jelutung Kec. Jelutung Kota Jambi
Email : mtstarbiyahislamiyahjelutung@gmail.com Hp / Wa : 082183587661

FORMULIR PENDAFTARAN

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

2. Jenis Kelamin : .................................................................................
3. Tempat Tgl Lahir : .................................................................................
4. Asal Sekolah : .................................................................................
5. Agama : .................................................................................
6. Jumlah Saudara : .................................................................................
a. Kandung : .................................................................................
b. Tiri : .................................................................................
c. Angkat : .................................................................................
7. Keadaan Jasmani
a. Berat Badan : .................................................................................
b. Tinggi Badan : .................................................................................
c. Riwayat Penyakit : .................................................................................
8. Alamat Rumah : .................................................................................
9. Bertempat Tinggal dengan : .................................................................................
10. Jarak Tempat Tinggal : .................................................................................
11. Data Ayah
a. Nama : .................................................................................
b. Pendidikan : .................................................................................
c. Pekerjaan : .................................................................................
d. No Hp : .................................................................................
12. Data Ibu
a. Nama : .................................................................................
b. Pendidikan : .................................................................................
c. Pekerjaan : .................................................................................
d. No Hp : .................................................................................
Jambi, 2024
Syarat pendaftaran yang harus dilampirkan Orang tua/wali murid
1. Foto copy ijazah SD/MI(jika ada) : 2 lembar
2. Akte Kelahiran : 2 lembar
3. Pas fhoto warna 3 x 4 : 3 lembar
4. Foto copy KK : 2 lembar
5. Foto copy Kartu PKH (jika Ada) : 1 lembar ..................................
6. Map folio warna Merah : 2 lembar
 Pendaftaran dilaksanakan tanggal 04 Maret – 30 Juli 2024
 Tempat pendaftaran di MI & MTs. Tarbiyah Islamiyah
 Waktu belajar pagi hari jam 07.00-14.00 WIB
YAYASAN TARBIYAH PERTI JAMBI
Nomor AHU-0002818.AH.01.04.2017

MTsS. TARBIYAH ISLAMIYAH

KECAMATAN JELUTUNG
TERAKREDITASI “B”
NPSN : 69754821 - NSM : 121215710026
Jl. Dr. Sumbiyono No. 02 RT 11 Kel. Jelutung Kec. Jelutung Kota Jambi
Email : mtstarbiyahislamiyahjelutung@gmail.com Hp / Wa : 082183587661