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MINISTERY OF EDUCATION AND CULTURE

REPUBLIC OF INDONESIA

DIPLOMA
No. ……………….

SENIOR HIGH SCHOOL


SPECIALIZATION OF MATHEMATICAL AND NATURE SCIENCE
YEAR OF STUDY 2020/2021

The undersigned, Headmaster of ..............................................................................................

....................................................................................................................................................

National Principal Number of School .........................................................................................

Region/City ................................................................................................................................

Province ............................................................................................................. , explained that:

Name : ....................................................................................

Place and date of birth : ....................................................................................

Name of parents/guardian : ....................................................................................

Student Identity Number : ....................................................................................

National Student Identity Number : ....................................................................................

HAS BEEN GRADUATED

from high school after fulfilling all the criteria in accordance with the law and regulations
promulgated on May 3, 2021.

.........................,............................2021
Headmaster,
Black and
white or
colored photo
(3X4cm)

Fingerprint

NIP ........................................................
SCORE LIST
SENIOR HIGH SCHOOL
SPECIALIZATION OF MATHEMATICAL AND NATURE SCIENCE
YEAR OF STUDY 2020/2021

Name : ...........................................................................................

Place and date of birth : ...........................................................................................

Student Identity Number : ...........................................................................................

National Student Identity Number : ...........................................................................................

No. Subject Score of


(Curriculum 2013) School Exam

Group A
1. Education of Religion and Character
2. Education of Pancasila and Citizenship
3. Indonesian language
4. Mathematic
5. History of Indonesia
6. English
Group B
1. Art and Culture
2. Education of Physical, Sports, and Health
3. Workshop and Entrepreneurship
4. Local Content
a.
b.
c.
Group C
1. Mathematic
2. Biology
3. Physics
4. Chemistry
5. Selection of Cross-interest / Interest
Deepening
……………………………………………………...
……………………………………………………...
Average

………………….. ,...............................2021
Headmaster,

NIP ..............................................................

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