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0 7 1 - PEMERINTAH KABUPATEN DELI SERDANG DINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGIN Jalan Pendidikan No. 3 Kecamatan Beringin 20552 Email : [email protected] NO. FORMULIR : KOMPETENSI KEAHLIAN : TEKNIK KOMPUTER & JARINGAN A. DATA PRIBADI CALON SISWA 1. Nama !engka" : ............................................................. 2. Jenis Kelamin : ............................................................. 3. #em"at dan #anggal !air : ............................................................. $. %gama : ............................................................. 5. %lamat : ............................................................. B. DATA ORANG TUA / WALI 1. Nama &rang #'a ( )ali : ......................................................... 2. %lamat : ......................................................... 3. Peker*aan : ......................................................... $. No. #el" ( +" : ......................................................... C. ASAL SEKOLAH 1. Nama ,ekola : ......................................................... 2. ,tat's : ......................................................... 3. %lamat ,ekola : ......................................................... -. NOMOR SKHUN ( Ditulis Jelas) : ........................................................ E. NILAI UJIAN NASIONAL ( SKHUN ) Nilai A!i" NO . MATA PELAJARAN NILAI (#) BOBOT NILAI JUMLAH 1. Baasa /ndonesia 2 2. Baasa /nggris 3 3. atematika $ $. /lm' Pengeta'an %lam 3 J$%la! Beringin J'ni 2015 engeta'i( enyet'*'i alon ,is4a &rang t'a( )ali Nama Jelas Nama Jelas PEMERINTAH KABUPATEN DELI SERDANG
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contoh formulir untuk keperluan pada sekolah menengah kejuaruan
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PEMERINTAH KABUPATEN DELI SERDANGDINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGINJalan Pendidikan No. 3 Kecamatan Beringin 20552Email : [email protected]
NO. FORMULIR: KOMPETENSI KEAHLIAN: TEKNIK KOMPUTER & JARINGAN
A. DATA PRIBADI CALON SISWA
1. Nama Lengkap: .......................................................................................................................2. Jenis Kelamin: .......................................................................................................................3. Tempat dan Tanggal Lahir: .......................................................................................................................4. Agama: .......................................................................................................................5. Alamat: .......................................................................................................................
B. DATA ORANG TUA / WALI
1. Nama Orang Tua / Wali: ..............................................................................................................2. Alamat: ..............................................................................................................3. Pekerjaan: ..............................................................................................................4. No. Telp / Hp: ..............................................................................................................
C. ASAL SEKOLAH
1. Nama Sekolah: ..............................................................................................................2. Status: ..............................................................................................................3. Alamat Sekolah: ..............................................................................................................
D. NOMOR SKHUN ( Ditulis Jelas ): ..............................................................................................................
E. NILAI UJIAN NASIONAL ( SKHUN ) = Nilai Akhir
NO.MATA PELAJARANNILAI(X) BOBOT NILAIJUMLAH
1.Bahasa IndonesiaX 2
2.Bahasa InggrisX 3
3.MatematikaX 4
4.Ilmu Pengetahuan AlamX 3
Jumlah
Beringin, Juni 2015Mengetahui/ Menyetujui,Calon SiswaOrang tua/ Wali
__________________________________________________Nama JelasNama JelasPEMERINTAH KABUPATEN DELI SERDANGDINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGINJalan Pendidikan No. 3 Kecamatan Beringin 20552Email : [email protected]
NO. FORMULIR: KOMPETENSI KEAHLIAN: REKAYASA PERANGKAT LUNAK
A. DATA PRIBADI CALON SISWA
1. Nama Lengkap: .......................................................................................................................2. Jenis Kelamin: .......................................................................................................................3. Tempat dan Tanggal Lahir: .......................................................................................................................4. Agama: .......................................................................................................................5. Alamat: .......................................................................................................................
B. DATA ORANG TUA / WALI
1. Nama Orang Tua / Wali: ..............................................................................................................2. Alamat: ..............................................................................................................3. Pekerjaan: ..............................................................................................................4. No. Telp / Hp: ..............................................................................................................
C. ASAL SEKOLAH
1. Nama Sekolah: ..............................................................................................................2. Status: ..............................................................................................................3. Alamat Sekolah: ..............................................................................................................
D. NOMOR SKHUN ( Ditulis Jelas ): ..............................................................................................................
E. NILAI UJIAN NASIONAL ( SKHUN ) = Nilai Akhir
NO.MATA PELAJARANNILAI(X) BOBOT NILAIJUMLAH
1.Bahasa IndonesiaX 2
2.Bahasa InggrisX 3
3.MatematikaX 4
4.Ilmu Pengetahuan AlamX 3
Jumlah
Beringin, Juni 2015Mengetahui/ Menyetujui,Calon SiswaOrang tua/ Wali
__________________________________________________Nama JelasNama JelasPEMERINTAH KABUPATEN DELI SERDANGDINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGINJalan Pendidikan No. 3 Kecamatan Beringin 20552Email : [email protected]
NO. FORMULIR: KOMPETENSI KEAHLIAN: KECANTIKAN KULIT
A. DATA PRIBADI CALON SISWA
1. Nama Lengkap: .......................................................................................................................2. Jenis Kelamin: .......................................................................................................................3. Tempat dan Tanggal Lahir: .......................................................................................................................4. Agama: .......................................................................................................................5. Alamat: .......................................................................................................................
B. DATA ORANG TUA / WALI
1. Nama Orang Tua / Wali: ..............................................................................................................2. Alamat: ..............................................................................................................3. Pekerjaan: ..............................................................................................................4. No. Telp / Hp: ..............................................................................................................
C. ASAL SEKOLAH
1. Nama Sekolah: ..............................................................................................................2. Status: ..............................................................................................................3. Alamat Sekolah: ..............................................................................................................
D. NOMOR SKHUN ( Ditulis Jelas ): ..............................................................................................................
E. NILAI UJIAN NASIONAL ( SKHUN ) = Nilai Akhir
NO.MATA PELAJARANNILAI(X) BOBOT NILAIJUMLAH
1.Bahasa IndonesiaX 2
2.Bahasa InggrisX 3
3.MatematikaX 3
4.Ilmu Pengetahuan AlamX 2
Jumlah
Beringin, Juni 2015Mengetahui/ Menyetujui,Calon SiswaOrang tua/ Wali
__________________________________________________Nama JelasNama JelasPEMERINTAH KABUPATEN DELI SERDANGDINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGINJalan Pendidikan No. 3 Kecamatan Beringin 20552Email : [email protected]
NO. FORMULIR: KOMPETENSI KEAHLIAN: AKOMODASI PERHOTELAN
A. DATA PRIBADI CALON SISWA
1. Nama Lengkap: .......................................................................................................................2. Jenis Kelamin: .......................................................................................................................3. Tempat dan Tanggal Lahir: .......................................................................................................................4. Agama: .......................................................................................................................5. Alamat: .......................................................................................................................
B. DATA ORANG TUA / WALI
1. Nama Orang Tua / Wali: ..............................................................................................................2. Alamat: ..............................................................................................................3. Pekerjaan: ..............................................................................................................4. No. Telp / Hp: ..............................................................................................................
C. ASAL SEKOLAH
1. Nama Sekolah: ..............................................................................................................2. Status: ..............................................................................................................3. Alamat Sekolah: ..............................................................................................................
D. NOMOR SKHUN ( Ditulis Jelas ): ..............................................................................................................
E. NILAI UJIAN NASIONAL ( SKHUN ) = Nilai Akhir
NO.MATA PELAJARANNILAI(X) BOBOT NILAIJUMLAH
1.Bahasa IndonesiaX 2
2.Bahasa InggrisX 3
3.MatematikaX 3
4.Ilmu Pengetahuan AlamX 2
Jumlah
Beringin, Juni 2015Mengetahui/ Menyetujui,Calon SiswaOrang tua/ Wali
__________________________________________________Nama JelasNama JelasPEMERINTAH KABUPATEN DELI SERDANGDINAS PENDIDIKAN, PEMUDA DAN OLAHRAGA SEKOLAH MENENGAH KEJURUAN NEGERI 1 BERINGINJalan Pendidikan No. 3 Kecamatan Beringin 20552Email : [email protected]
NO. FORMULIR: KOMPETENSI KEAHLIAN: TATA BUSANA BUTIK
A. DATA PRIBADI CALON SISWA
1. Nama Lengkap: .......................................................................................................................2. Jenis Kelamin: .......................................................................................................................3. Tempat dan Tanggal Lahir: .......................................................................................................................4. Agama: .......................................................................................................................5. Alamat: .......................................................................................................................
B. DATA ORANG TUA / WALI
1. Nama Orang Tua / Wali: ..............................................................................................................2. Alamat: ..............................................................................................................3. Pekerjaan: ..............................................................................................................4. No. Telp / Hp: ..............................................................................................................
C. ASAL SEKOLAH
1. Nama Sekolah: ..............................................................................................................2. Status: ..............................................................................................................3. Alamat Sekolah: ..............................................................................................................
D. NOMOR SKHUN ( Ditulis Jelas ): ..............................................................................................................
E. NILAI UJIAN NASIONAL ( SKHUN ) = Nilai Akhir
NO.MATA PELAJARANNILAI(X) BOBOT NILAIJUMLAH
1.Bahasa IndonesiaX 2
2.Bahasa InggrisX 3
3.MatematikaX 3
4.Ilmu Pengetahuan AlamX 2
Jumlah
Beringin, Juni 2015Mengetahui/ Menyetujui,Calon SiswaOrang tua/ Wali
__________________________________________________Nama JelasNama Jelas
