Transcript

PEMERINTAH KABUPATEN ACEH TENGAHDINAS PENDIDIKANSEKOLAH MENENGAH KEJURUAN (SMK) NEGERI 2 TAKENGONJln. Takengon-Isaq, Km.08 Wih Nareh Pegasing, Kode Pos : 24561Telp/Fax : (0643) 7246451 Takengon Aceh TengahE-mail : [email protected]

FORMULIR PENDAFTARANPENERIMAAN PESERTA DIDIK BARU (PPDB) Tahun Pelajaran 2015/201602--0

NOMOR PESERTA: NAMA PESERTA: .....................................................................................................................................................NISN: .....................................................................................................................................................TEMPAT, TANGGAL LAHIR: .....................................................................................................................................................AGAMA: .....................................................................................................................................................ASAL SEKOLAH: .....................................................................................................................................................ALAMAT PESERTA: .....................................................................................................................................................NO. TELP/HP: .....................................................................................................................................................IDENTITAS SISWA: Tinggi : ............. CmBerat : ............... KgREKAP NILAI RAPORT (RENTANG NILAI 0-10)NOMATA PELAJARANNILAI/SEMESTERJUMLAH

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1BAHASA INDONESIA

2BAHASA INGGRIS

3MATEMATIKA

4IPA

JUMLAH TOTAL

REKAP NILAI UN MURNINOMATA PELAJARANMATA PELAJARANJUMLAH

B.INDB.INGGMMIPA

1NILAI MURNI

PRESTASI PERORANGAN :NOBIDANG PRESTASIPERINGKATTINGKATTAHUN

1

2

Keterangan :1. Melampirkan Ijazah, Melampirkan SKHUN Asli, dan Surat Keterangan Lulus Asli dari Sekolah Asal2. Pas Photo Warna 3 x 4 sebanyak 2 lembar3. Melampirkan Foto Copy Raport SMP Semester 1 s.d 5 dilegalisir4. Photo Copy Kartu Keluarga5. Biaya Test dan Map Rp. 25.000,-

Takengon, ..............................................2015PESERTA/SISWA, ORANG TUA SISWA,

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