format-format pendampingan k13
DESCRIPTION
format pendampingan K-13TRANSCRIPT
Lampiran 2. Agenda Kegiatan Tim Pendamping Implementasi Kurikulum 2013Tahun 2015
AGENDA KEGIATAN ON PENDAMPINGAN IMPLEMENTASI KURIKULUM 2013 TAHUN 2015
(FORMAT-01)
Nama SMA : SMAN 5 Kota BimaAlamat : Jl. Gindi No 5 Kota BimaKepala Sekolah : D r s . H. Sudirman HINo HP Kasek : 08123456789Tim Pendamping :1. Sucipto ; Asal SMA : SMAN 1 Kota Bima Mapel : Sejarah No. HP :081234567882. Masyhudin Asal SMA : SMAN 1 Kota Bima Mapel : Kimia No. HP : 081999911113. Muhammad. Nur Asal SMA : SMAN 1 Woja Mapel : Ekonomi No. HP : 08122897384. Feni Dwi F Asal SMA : SMAN 1 Kota Bima Mapel : B. Inggris No. HP : 08533395725. Drs. M. Kasim Asal SMA : SMAN 5 Kota Bima Mapel : PJOK No. HP : 0819186577367
No. Tanggal Kegiatan1. 15 Oktober 2015 1. Menenmui guru sasaran sesui jadewal yang disepakati
2. Observasi perangkat pembelajaran3. Observasi pelaksanaan implematasi RPP dalam kelas4. Diskusi dan refleksi guru sasaran dan pendamping:- Progres administrasi pembelajaran- Progres pelaksanaan pembalajaran5. Umpan balik dan perbaikan
2. 16 Oktober 2015 1. Menenmui guru sasaran sesui jadewal yang disepakati2. Observasi perangkat pembelajaran3. Observasi pelaksanaan implematasi RPP dalam kelas4. Diskusi dan refleksi guru sasaran dan pendamping:- Progres administrasi pembelajaran- Progres pelaksanaan pembalajaran5. Umpan balik dan perbaikan6. Melaporkan proses dan hasil ON 2 kepada kepala sekolah7. Menyepakati program tindak lajut
MengetahuiKepala SMA N 5 Kota Bima
Drs. H. Sudirman HI NIP. NIP. 19650405 198802 1004
Kota Bima, 16 Oktober 2015Koordinator Tim Pendamping,
Sucipto , S.PdNIP. ...................................
Lampiran 3. Daftar Hadir Tim Pendamping Implementasi Kurikulum 2013 Tahun 2015
DAFTAR HADIR TIM PENDAMPING IMPLEMENTASI KURIKULUM 2013 TAHUN 2015 (FORMAT-02)
Nama SMA : SMAN 5 Kota Bima Alamat : Jl. Gindi 5 Kota Bima Kegiatan : On- 1/On-2 *)
No. Tanggal Nama Pendamping Tandatangan1. 15 Oktober 2015 1. Sucipto
2. Masyhudin
3.Muhammad Nur
4. Feni Dwi F
5. M. Kasim
2. 16 Oktober 2015 1. Sucipto
2. Masyhudin
3.Muhammad Nur
4. Feni Dwi F
5. M. Kasim
*) Coret yang tidak sesuai kegiatan
Kota Bima, 16 Oktober 2015Kepala SMA N 5 Kota Bima
Drs. H. Sudirman HINIP. 19650405 198802 1004
Lampiran 4. Jurnal Kegiatan Tim Pendamping Implementasi Kurikulum 2013Tahun 2015
JURNAL KEGIATAN TIM PENDAMPING IMPLEMENTASI KURIKULUM 2013 TAHUN 2015 (FORMAT-03)
Nama SMA : .............................. Alamat : .............................. Kegiatan : On-1/On-2 *)
No. Tanggal JamNama
Pendamping KegiatanTandatanganPendamping
TandatanganGuru Sasaran
1. 1. ......................
2. ......................
3. ......................
4. ......................
5. ......................
2. 1. ......................
2. ......................
3. ......................
4. ......................
5. ......................
*) Coret yang tidak sesuai kegiatan
..................................., ........................... 2015Kepala SMA ......................................
............................................. NIP. ...................................
Lampiran 5. Hasil Pengamatan Tim Pendamping Implementasi Kurikulum 2013Tahun 2015
HASIL PENGAMATAN TIM PENDAMPING IMPLEMENTASI KURIKULUM 2013 TAHUN 2015 (FORMAT-04)
Nama SMA : .............................. Alamat : .............................. Kegiatan : On-1/On-2 *)
No. MateriKeberhasilan/ Keunggulan/Praktek Baik
Permasalahan Saran/Solusi/ Tindak Lanjut
1. KTSP2. Peminatan,
Lintas Minat, Pendalaman Minat
3. RPP4. Pembelajaran5. Penilaian6. Kepramukaan7. Mulok8. SKS9. Budaya sekolah
*) Coret yang tidak sesuai kegiatan
MengetahuiKepala SMA ......................................
............................................. NIP. ...................................
..................................., ........................... 2015Koordinator Tim Pendamping,
............................................. NIP. ...................................
Lampiran 7. Biodata Tim Pendamping Implementasi Kurikulum 2013 Tahun 2015
BIODATATIM PENDAMPING IMPLEMENTASI KURIKULUM 2013
TAHUN 2015
A. IDENTITAS DIRI
1. Nama : ........................................................2. Tempat, Tanggal Lahir : ........................................................3. Jenis Kelamin : ........................................................4. Pendidikan : ........................................................5. Alamat Rumah : ........................................................6. No. HP : ........................................................7. Email : ........................................................
B. IDENTITAS SEKOLAH TEMPAT MENGAJAR
1. Nama SMA : ........................................................2. Alamat SMA : ........................................................3. Telpon : ........................................................4. Faximili : ........................................................5. Email : ........................................................
C. PENGALAMAN MENGAJAR
1. Matapelajaran Diampu : ........................................................2. Kelas : ........................................................3. Lama Mengajar Mapel Diampu : ........................................................4. Buku yang pernah disusun : ........................................................
........................................................
........................................................5. Media pembelajaran yang pernah disusun : ........................................................6. Penghargaan yang pernah diterima : ........................................................
........................................................
........................................................
D. PENGALAMAN PELATIHAN/WORKSHOP/BIMTEK
1. Pelatihan/Workshop/Bimtek Kurikulum 3 tahun terakhir.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
2. Pelatihan/Workshop/Bimtek lainnya 3 tahun terakhir.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Demikian informasi yang termuat dalam biodata ini saya buat dengan sebenar-benarnya.
..............................., ....................... 2015Pendamping
........................................................ NIP. ..............................................
46©2015, Direktorat Pembinaan SMA- Direktorat Jenderal Pendidikan Menengah
Lampiran 7.1. Biodata Peserta Tim Pendamping Implementasi Kurikulum 2013 Tahun 2015
BIODATAPESERTA BIMTEK PENDAMPING IMPLEMENTASI
KURIKULUM 2013TAHUN 2015
A. IDENTITAS DIRI
1. Nama : ........................................................2. Tempat, Tanggal Lahir : ........................................................3. Jenis Kelamin : ........................................................4. Pendidikan : ........................................................5. Alamat Rumah : ........................................................6. No. HP : ........................................................7. Email : ........................................................
B. IDENTITAS SEKOLAH TEMPAT MENGAJAR
1. Nama SMA : ........................................................2. Alamat SMA : ........................................................3. Telpon : ........................................................4. Faximili : ........................................................5. Email : ........................................................
C. PENGALAMAN MENGAJAR
1. Matapelajaran Diampu : ........................................................2. Kelas : ........................................................3. Lama Mengajar Mapel Diampu : ........................................................4. Buku yang pernah disusun : ........................................................
........................................................
........................................................5. Media pembelajaran yang pernah disusun : ........................................................6. Penghargaan yang pernah diterima : ........................................................
........................................................
........................................................
D. PENGALAMAN PELATIHAN/WORKSHOP/BIMTEK
1. Pelatihan/Workshop/Bimtek Kurikulum 3 tahun terakhir.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
2. Pelatihan/Workshop/Bimtek lainnya 3 tahun terakhir..........................................................................................................................................................................................................................................................................................................................
Demikian informasi yang termuat dalam biodata ini saya buat dengan sebenar-benarnya.
..............................., ....................... 2015
........................................................
NIP. ..............................................
Lampiran 8. Action Plan Pendampingan Implementasi Kurikulum 2013 Tahun 2015
ACTION PLAN PENDAMPINGAN IMPLEMENTASI KURIKULUM 2013PERIODE : SEPTEMBER/OKTOBER 2015 - JUNI 2016
SMA ............................................................
No. Kegiatan Uraian Kegiatan Sasaran/Out put Tanggal PenanggungJawab
1. PengembanganKTSP
a. ………………………. b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................2. Pengembangan
RPPa. ................................... b. ...................................c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................3. Pelaksanaan
pembelajarana. ................................... b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................4. Pelaksanaan
penilaiana. ................................... b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................5. Kepramukaan a. ...................................
b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................6. Pengembangan
muatan lokala. ................................... b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................7. Pengembangan
peminatan, lintas minat dan pendalamanminat
a. ................................... b. ................................... c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................
8. PengembanganSKS
a. ................................... b. ...................................c. ................................... d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................9. Pengembangan
budaya sekolaha. ................................... b. ...................................c. ...................................d. ...................................
...........................
...........................
...........................
...........................
...................
...................
...................
...................
...........................
...........................
...........................
...........................10. Kegiatan On-111. Kegiatan On-2
..................................., ........................... 2015Kepala SMA ....................................
NIP ....................................