CONTOH FORMULIR PENDAFTARAN SISWA BARU PAUD

PAUD – TAMAN PENDIDIKAN ALQUR’AN

DUKUH KATAM  RANDUDONGKAL PEMALANG

Alamat : Jalan Ki Hajar Dewantoro RT 61 RW 06 Randudongkal

FORMULIR PENDAFTARAN

Data Anak

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

2.    Nama Panggilan               :  ..........................................................................................

3.    Jenis Kelamin                     :  ..........................................................................................

4.    Tempat Tanggal Lahir      :  ..........................................................................................

5.    Alamat                               :  ..........................................................................................

6.    Status Anak                       :  ..........................................................................................

7.    Bahasa sehari-hari                        :  ..........................................................................................

8.    Anak Ke-                           :  ..........................................................................................

9.    Jumlah saudara                 :  ..........................................................................................

a.      Saudara kandung       :  ..........................................................................................

b.      Saudara Tiri                 :  ..........................................................................................

c.       Saudara Angkat          :  ..........................................................................................

Data Ayah

1.    Nama Ayah                       :  ..........................................................................................

2.    Alamat                               :  ..........................................................................................

3.    Tempat tanggal lahir        :  ..........................................................................................

4.    Pekerjaan                           :  ..........................................................................................

Data Ibu

1.    Nama Ayah                       :  ..........................................................................................

2.    Alamat                               :  ..........................................................................................

3.    Tempat tanggal lahir        :  ..........................................................................................

4.    Pekerjaan                           :  ..........................................................................................

Randudongkal, .........................................

Orang Tua Murid

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