SEKOLAH KEBANGSAAN BUKIT SELAMBAU, BUKIT SELAMBAU

08010 SUNGAI PETANI, KEDAH

__________________________________________________________________________________
MAKLUMAT MURID DALAM SISTEM PENGURUSAN SEKOLAH TAHUN 2017
(SILA GUNAKAN HURUF BESAR SAHAJA)
__________________________________________________________________________________
(A) MAKLUMAT PERIBADI MURID
1. Nama Penuh* :
____________________________________________________________
2. Tarikh Kemasukan ke sekolah sekarang* : ___________________
3. No. Pendaftaran: _________________
Tahun / Kelas :
_________________
4. No. Kad Pengenalan : __________________________

No.Surat Beranak :

______________
5. Tarikh Lahir* : ___________________

Agama* :

_____________________
6. Bangsa* : _______________________

Jantina* :

_____________________
7. Alamat* : _________________________________________________________
_________________________________________________________
Bandar *: _________________________________________________________
Poskod* : __________________________________
Negeri *: ________________________
8. Kewarganegaraan * : ______________________________
9. Status Murid Anak Yatim : YA / TIDAK
10.Bilangan Isi Rumah : ____________________
Bilangan Yang Masih Belajar :
____________
11.Anak Ke Berapa : _________________
12.Bilangan Adik Beradik Terima SPBT : ___________________
13.Bilangan Adik Beradik Terima RMT : ___________________ KWAMP :
_________________
14.Bilangan Adik Beradik Tinggal Di Asrama : _______________
15.Jarak Rumah Ke Sekolah (km) : _________
Cara KeSekolah :
____________________
16.Masalah Kesihatan :
__________________________________________________________
17.Kumpulan Darah : ______________________
18.Tinggi (cm) : __________________________
Berat (kg) :
______________________
19.Kategori OKU : _________________________________________________
20.No. OKU : _____________________________

(B) MAKLUMAT KELUARGA

I ) MAKLUMAT PENJAGA
1. Nama Penjaga : ___________________________________________
2. Status Penjaga : __________________________________________________
3. Alamat : _________________________________________________________
_________________________________________________________
_________________________________________________________
4. No. Telefon : ____________________

No: H/p :

_____________________________
5. No. Kad Pengenalan : __________________________
6. Tarikh Lahir : _______________ Tempat Lahir :
_______________________________
7. Bangsa : ____________________
Agama : ____________________
8. Pekerjaan : ___________________________________________________
9. Nama Majikan : ________________________________________________________
10.Pendapatan Bulanan (RM): _______________________
II ) MAKLUMAT BAPA
1. Nama Bapa : ___________________________________________
2. Status Bapa : __________________________________________________
3. Alamat : _________________________________________________________
_________________________________________________________
_________________________________________________________
4. No. Telefon : __________________________

No: H/p :

_____________________________
5. No. Kad Pengenalan : __________________________
6. Tarikh Lahir : ___________________
Tempat Lahir :
________________________________
7. Bangsa : ____________________
Agama : ____________________
8. Pekerjaan : ___________________________________________________
9. Nama Majikan : ________________________________________________________
10.Alamat majikan:
______________________________________________________________
_____________________________________________________________
______________________________________________________________
11.No. Telefon Pejabat : _________________________
12.Pendapatan Bulanan (RM): _______________________
13.No. Cukai Pendapatan : _______________________________

II ) MAKLUMAT IBU
1. Nama Ibu : _______________________________________________________
2. Status Ibu : ______________________________________________________
3. Alamat : _________________________________________________________

_________________________________________________________
_________________________________________________________
4. No. Telefon : _____________________

No: H/p :

_____________________________
5. No. Kad Pengenalan : __________________________
6. Tarikh Lahir : _________________ Tempat Lahir :
________________________________
7. Bangsa : ____________________
Agama : ____________________
8. Pekerjaan : ___________________________________________________
9. Nama Majikan : ________________________________________________________
10.Alamat majikan
:_____________________________________________________________
______________________________________________________________
______________________________________________________________
11.No. Telefon Pejabat : _________________________
12.Pendapatan Bulanan (RM): _______________________
13.No. Cukai Pendapatan : _______________________________
III ) MAKLUMAT ADIK-BERADIK
Adik-beradik (1)
1. Nama: _____________________________________________________
2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. TahapPersekolahan : _______________________________________
5. BantuanKewangan : _____________________________________________
Adik-beradik (2)
1. Nama: _____________________________________________________
2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. Tahap Persekolahan : _______________________________________
5. Bantuan Kewangan : _____________________________________________

Adik-beradik (3)
1. Nama: _____________________________________________________

2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. Tahap Persekolahan : _______________________________________
5. Bantuan Kewangan : _____________________________________________
Adik-beradik (4)
1. Nama: _____________________________________________________
2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. Tahap Persekolahan : _______________________________________
5. Bantuan Kewangan : _____________________________________________
Adik-beradik (5)
1. Nama: _____________________________________________________
2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. Tahap Persekolahan : ____________________________________________
5. Bantuan Kewangan : _____________________________________________
Adik-beradik (6)
1. Nama: _____________________________________________________
2. Sekolah / Majikan :
_________________________________________________________
3. Umur : __________________________
Hubungan :
________________________
4. Tahap Persekolahan : _______________________________________
5. Bantuan Kewangan : _____________________________________________
BAGI MURID YANG TINGGAL BERSAMA PENJAGA
1. SebabTinggal :
_______________________________________________________________
2. Sejak (Tahun) : ________________

C ) MAKLUMAT UNTUK DIHUBUNGI

MAKLUMAT PERHUBUNGAN (1)
1.
2.
3.
4.

NamaPenuh : _____________________________________________________
Hubungan : ________________________
Pekerjaan : _______________________________________________________
Agama : ________________________________
Bangsa :

_____________________
5. Alamat Rumah :
___________________________________________________________
___________________________________________________________
___________________________________________________________
6. No. Telefon : ___________________________

No. H/p :

____________________________
7. Alamat Pejabat :
___________________________________________________________
___________________________________________________________
___________________________________________________________

* SILA SERAHKAN BORANG YANG TELAH LENGKAP DIISI

KEPADA GURU KELAS
SELEWAT-LEWATNYA 17 NOVEMBER 2016 (KHAMIS)