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PENGAJUAN SURAT MUTASI KELUAR
UPT SD NEGERI 117 GRESIK
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NAMA SISWA
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KELAS
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I (SATU) A
I (SATU) B
II (DUA) A
II (DUA) B
III (TIGA) A
III (TIGA) B
IV (EMPAT) A
IV (EMPAT) B
V (LIMA) A
V (LIMA) B
VI (ENAM) A
VI (ENAM) B
NIS (Nomor Induk Sekolah)
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Input Nomor Induk Siswa yang mutasi
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Sekolah Tujuan
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Alamat Sekolah Tujuan
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Alasan Pindah
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Tanggal Pindah
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MM
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DD
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YYYY
Nomor Surat Keluar
(Diisi oleh petugas sekolah)
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Email Aktif
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