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3. SURAT PERNYATAAN PSB 2009

3. SURAT PERNYATAAN PSB 2009

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Published by oom_guru

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Published by: oom_guru on Apr 27, 2009
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05/21/2010

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SURAT PERNYATAANSISWA SMK AMALIYAH JAKARTA
Saya yang bertanda tangan di bawah ini :
1.
Nama Lengkap:.........................................................................................
2.
 Tempat dan Tanggal Lahir:.........................................................................................
3.
Agama:.........................................................................................
4.
Nomor Pendaftaran Siswa Baru:.........................................................................................
5.
Nama Orangtua/Wali:.........................................................................................
6.
Agama Orangtua/Wali:.........................................................................................
7.
Pekerjaan Orangtua/Wali:.........................................................................................
8.
Hubungan Keluarga dengan Wali:.........................................................................................
9.
Alamat Orangtua/Wali:.........................................................................................Dengan sungguh-sungguh dan penuh kesadaran,
MENYATAKAN

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