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FORMULIR PENDAFTARAN PPDB ONLINE JALUR MITRA SEKOLAH SMAN 3 JAYAPURA
Formulir ini hanya diperuntukkan untuk kerjasama SMA Negeri 3 Jayapura dengan mitra sekolah YPMAK Timika
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NAMA LENGKAP (SESUAI IJASAH SMP)
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Your answer
NISN
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Your answer
NOMOR KARTU KELUARGA
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Your answer
NOMOR INDUK KEPENDUDUKAN (NIK)
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Your answer
ASAL SUKU
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AMUNGME
KAMORO
TEMPAT DAN TANGGAL LAHIR
MM
/
DD
/
YYYY
AGAMA
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KRISTEN PROTESTAN
KATOLIK
ISLAM
HINDU
BUDHA
JENIS KELAMIN
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LAKI-LAKI
PEREMPUAN
ALAMAT RUMAH SISWA (LENGKAP RT, RW, KEL DAN KEC)
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Your answer
JUMLAH SAUDARA KANDUNG
Your answer
NOMOR HP
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Your answer
ASAL SEKOLAH
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Your answer
ALAMAT SEKOLAH
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Your answer
NO TELP/HP SEKOLAH
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Your answer
NAMA AYAH KANDUNG
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Your answer
PEKERJAAN AYAH
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Your answer
NO HP AYAH
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Your answer
NAMA IBU KANDUNG
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Your answer
PEKERJAAN IBU
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Your answer
NO HP IBU
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Your answer
NAMA WALI (DOMISILI KOTA/KAB JAYAPURA)
Your answer
PEKERJAAN WALI
Your answer
ALAMAT WALI DI KOTA/KAB JAYAPURA
Your answer
NO HP WALI
Your answer
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