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FORMULIR PPDB SMK ISLAM MANBA'UL ULUM TP. 2020/2021
Diisi sesuai dengan Ijazah/Akta Kelahiran
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Nomor Pendaftaran
Silahkan Meminta Nomor Pendaftaran Ke Panitia / Hubungi 085 201 052 502
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Pilih Program Keahlian
*
Otomatisasi dan Tata Kelola Perkantoran (OTKP)
Teknik dan Bisnis Sepeda Motor (TBSM)
Nama Lengkap
*
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Tempat Lahir
*
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Tanggal Lahir
*
MM
/
DD
/
YYYY
Jenis Kelamin
*
Laki - laki
Perempuan
NISN
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NIS (Nomor Induk Sekolah)
*) Dikosongi diisi oleh petugas
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Nomor Seri Ijazah
* diisi jika Sudah menerima ijazah (nomor tertera di bagian bawah Ijazah contoh : DN-03 D xxxxxxxxx / MTs. xxxxxxx)
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Nomor Seri SHUN
* diisi jika Sudah menerima SHUN (nomor tertera di bagian bawah SHUN contoh : DN-03 D xxxxxxxxx)
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Nomor Ujian Nasional /UNBK
contoh : 2-19-03-23-xxxx-xx-x (Lihat di kartu ujian / Surat Kelulusan)
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No. Induk Kependudukan (NIK)
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Nomor Akta Kelahiran
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Sekolah Asal
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