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DATA PRIBADI SISWA
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* Indicates required question
Nama lengkap
*
Your answer
Nama Panggilan
*
Your answer
Jenis Kelamin
*
Choose
Laki - laki
Perempuan
Tempat, Tanggal lahir
*
Your answer
Usia
*
Your answer
Agama
*
Your answer
Alamat rumah
*
Your answer
Telepon rumah
*
Your answer
Telepon Handphone
*
Your answer
Anak ke ...
*
Your answer
Nama Ayah
*
Your answer
Tempat tanggal lahir Ayah
*
Your answer
Umur Ayah
*
Your answer
Suku bangsa Ayah
*
Your answer
Agama
*
Your answer
Ayah anak ke ... dari ... bersaudara
*
Your answer
Pendidikan terakhir
*
SMP
SMA
S1
S2
S3
Profesor
Required
Pekerjaan saat ini
*
Your answer
Opsi 1
Clear selection
Opsi 1
Clear selection
Alamat tempat tinggal
*
Your answer
Nomor telepon rumah
Your answer
Nomor telepon HP
Your answer
Nomor telepon kantor
*
Your answer
Nama Ibu ...
*
Your answer
Tempat tangggal lahir Ibu ...
*
Your answer
Umur Ibu ...
*
Your answer
Suku bangsa
*
Your answer
Agama
*
Your answer
Anak ke ... dari ... bersaudara
*
Your answer
Pendidikan terakhir
*
SMP
SMA
S1
S2
S3
Profesor
Required
Pekerjaan sekarang ...
*
Your answer
Alamat ...
*
Your answer
Nomor telepon rumah
Your answer
Nomor telepon Handphone
*
Your answer
Nomor telepon kantor
Your answer
Keadaan Ayah
*
Masih hidup
Sudah Meninggal
Required
Keadaan Ibu
*
Masih hidup
Sudah meninggal
Required
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