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PENGESAHAN KEMASUKAN PELAJAR TINGKATAN 1 KE SMKA AL-IRSHAD TAHUN 2023
SMKA AL-IRSHAD, SEKOLAH BERPRESTASI TINGGI
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PENERIMAAN TAWARAN KE SMKA AL-IRSHAD :
*
TERIMA
TIDAK TERIMA
PERMOHONAN ASRAMA :
*
YA
TIDAK
NAMA PELAJAR : (Huruf besar)
*
Your answer
JANTINA :
*
LELAKI
PEREMPUAN
NO. KAD PENGENALAN / SURAT BERANAK :
*
Your answer
ALAMAT PENUH :
Your answer
JARAK RUMAH KE SEKOLAH (dalam km):
*
Your answer
BILANGAN ISI KELUARGA :
*
Your answer
STATUS KESIHATAN MURID :
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Kencing manis (Diabetes)
Lelah (Asthma)
Penyakit jantung
Darah tinggi
Penyakit buah pinggang
Sawan (Epilepsi)
Masalah darah (Thalassemia, Anaemia, dll)
Tiada berpenyakit
Lain-lain penyakit
Required
STATUS MURID :
ANAK YATIM
BUKAN ANAK YATIM
Clear selection
SEBAB MEMOHON ASRAMA :
Your answer
NAMA WARIS :
Your answer
NOMBOR TELEFON 1 :
Your answer
NOMBOR TELEFON 2 :
Your answer
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