formulir paud 2015
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PEMERINTAH KABUPATEN TANJUNG JABUNG TIMUR PENDIDIKAN ANAK USIA DINI ( PAUD ) KELOMPOK BERMAIN AL – MADANI KELURAHAN PARIT CULUM I KECAMATAN MUARA SABAK BARAT FORMULIR PENDAFTARAN ANAK Nomor :......................................... A. Identitas Anak Nama Lengkap :...................................................................... ........................................................................... Nama Panggilan :...................................................................... ........................................................................... Tempat Tanggal Lahir:........................................................................ ......................................................................... Jenis Kelamin :...................................................................... ........................................................................... Agama :............................................................ .............................................................................. ....... Anak Ke :...................................................................... ........................................................................... Jumlah Saudara :...................................................................... ........................................................................... Alamat Rumah :...................................................................... ........................................................................... B. Kondisi Tumbuh Kembang Anak Berat Badan :....................................................................... .......................................................................... Tinggi Badan :....................................................................... .......................................................................... Lingkar Kepala :....................................................................... ..........................................................................
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Transcript of formulir paud 2015
PEMERINTAH KABUPATEN TANJUNG JABUNG TIMURPENDIDIKAN ANAK USIA DINI ( PAUD )
KELOMPOK BERMAIN AL – MADANI KELURAHAN PARIT CULUM IKECAMATAN MUARA SABAK BARAT
FORMULIR PENDAFTARAN ANAK Nomor :.........................................
A. Identitas AnakNama Lengkap :.................................................................................................................................................Nama Panggilan :.................................................................................................................................................Tempat Tanggal Lahir:.................................................................................................................................................Jenis Kelamin :.................................................................................................................................................Agama :.................................................................................................................................................Anak Ke :.................................................................................................................................................Jumlah Saudara :.................................................................................................................................................Alamat Rumah :.................................................................................................................................................
B. Kondisi Tumbuh Kembang AnakBerat Badan :.................................................................................................................................................Tinggi Badan :.................................................................................................................................................Lingkar Kepala :.................................................................................................................................................Penyakit / Gangguan:.................................................................................................................................................
Yang sering diderita :................................................................................................................................................. Yang pernah diderita:.................................................................................................................................................
C. Identitas Orang Tua / WaliNama Ayah :..................................................................................................................................................Umur Ayah :..................................................................................................................................................Pendidikan Ayah :..................................................................................................................................................Pekerjaan Ayah :..................................................................................................................................................Nama Ibu :..................................................................................................................................................Umur Ibu :..................................................................................................................................................Pendidikan Ibu :..................................................................................................................................................Pekerjaan Ibu :..................................................................................................................................................Nama Wali :.................................................................................................................................................Klasifikasi Kesejahteraan : Kurang mampu / Sedang / MampuNomor HP Ibu :..................................................................................................................................................Diterima di PAUD,Tanggal :.........................................................................................................................................
Muara Sabak Barat, ...............................2015 Orang Tua / Wali Calon Siswa
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Persyaratan :
1. Fotocopy Akte Kelahiran 2 lembar2. Foto berwarna 3 x 4 = 4 lembar3. Membayar uang pendaftaran
