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FORMULIR PENDAFTARAN 2022
Al-Inayah Islamic Primary School
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Email
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NAMA LENGKAP
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NAMA PANGGILAN
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TEMPAT LAHIR
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TANGGAL LAHIR
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MM
/
DD
/
YYYY
JENIS KELAMIN
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Laki-laki
Perempuan
NIK
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ALAMAT
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RT
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RW
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KELURAHAN
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KECAMATAN
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KODE POS
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ANAK KE
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DARI .......... BERSAUDARA
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BAHASA SEHARI-HARI
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Bahasa Indonesia
Bahasa Jawa
Bahasa Madura
TINGGI BADAN
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BERAT BADAN
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MINAT / KECENDERUNGAN
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ASAL SEKOLAH
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NAMA AYAH
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TTL AYAH
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Contoh: Surabaya, 15 Mei 1990
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PENDIDIKAN TERAKHIR AYAH
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NAMA SEKOLAH LULUSAN AYAH
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PEKERJAAN AYAH
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NO. HP AYAH
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NAMA IBU
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TTL IBU
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Contoh: Surabaya, 15 Mei 1990
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PENDIDIKAN TERAKHIR IBU
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NAMA SEKOLAH LULUSAN IBU
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PEKERJAAN IBU
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NO. HP IBU
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