JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
PERMOHONAN INFORMASI PUBLIK
Isilah Identitas Pemohon
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Nama
Your answer
Alamat
Your answer
No. KTP/ SIM/ Passport / Kartu Mahasiswa
Your answer
Nomor Telepon/ HP
Your answer
Pekerjaan
Mahasiswa
PNS/ TNI/ Polri
Wiraswasta
Mengurus Rumah Tangga
Lainnya
Clear selection
Rincian Informasi Yang Dibutuhkan
Your answer
Pengguna Informasi
Pribadi
Instansi
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Kementerian Pendidikan dan Kebudayaan (SMA).
Report Abuse
Forms
