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Formulir Pendaftaran Mahasantri Baru Program Pasca Aliyah Takhossus Tahfidz Al-Qur'an (PATTA) Salafiyah Kajen Tahun Pelajaran 2020-2021
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Nama Lengkap
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Your answer
Jenis Kelamin
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Laki-laki
Perempuan
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Agama
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Tempat Lahir
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Tanggal Lahir
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MM
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DD
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YYYY
Alamat Lengkap
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NIK (Nomor Induk Kependudukan)
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Asal Sekolah/Pondok (Pendidikan Terakhir)
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Jumlah Hafalan Al-Qur'an ( Berapa Juz ?)
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1 - 5 juz
6 - 10 juz
11 - 15 juz
16 - 20 juz
21 - 25 juz
26 - 30 juz
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Nama Ayah
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Tempat, Tanggal Lahir Ayah
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Pekerjaan Ayah
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Nama Ibu
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Tempat, Tanggal Lahir Ibu
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Pekerjaan Ibu
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Prestasi akademik atau non-akademik (jika punya)
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No Handphone (kontak yang bisa dihubungi)
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