SMP/MTs/SMA/MA/SMK

BIODATA PESERTAPENDATAAN UJIAN NASIONAL SMP/MTs, SMA/MA dan SMK DINAS PENDIDIKAN KUTAI BARAT TAHUN 2011/2012

Nama NIP Jabatan Pangkat/Gol. Unit Kerja Alamat Sekolah Kode Pos Telp. Sekolah Alamat Rumah Kode Pos Telp. Rumah No. HP(harus diisi)

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Alamat email(harus memiliki)

Website

Nama Sekolah NIP No. HP (Kepsek)(harus diisi)

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Nama Kepala Sekolah : ...............................................................................................................................

........................, ...................................... 2010 Mengetahui, Kepala Sekolah Peserta,

. NIP. ..

. NIP. ..

Bidang Peningkatan Mutu Pendidikan Dinas Pendidikan Kutai Barat email: disdik_kubar_pmp@yahoo.com