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PENDAFTARAN SANTRI BARU SMP dan SMA Islam Al Aly Tahun Akademik 2023/ 2024
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DATA PRIBADI
JENJANG YANG DIPILIH
SMP
SMA
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Nama Lengkap
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Jenis Kelamin
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Perempuan
Berkebutuhan Khusus (Bisa Pilih Lebih dari Satu Pilihan)
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Daksa Ringan
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Tuna Ganda
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NISN
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Alamat Jalan
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RT
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RW
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Nama Dusun (Jika Ada)
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Nama Kelurahan/ Desa
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Kecamatan
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Kabupaten
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