Formulir Data Siswa Baru

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{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \
hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \
cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \
lin0 \rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \trowd \trql \
trgaph0 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \trftsWidth1 \trftsWidthB3 \
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \
langfenp1033 \alang1025 \cell }\pard \plain \qc \li0 \ri2618 \lisb0 \sa0 \lisa0 \
sl-339 \slmult0 \nowidctlpar \lin0 \rin2618 \phmrg \pvpara \posx709 \posy933 \intbl
\itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \
af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
{\rtlch \fcs1 \af6 \afs29 \ltrch \fcs0 \b1 \fs29 \rtlch \alang1025 \ltrch \dbch \
af0 \hich \af6 \loch \f6 \charscalex99 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 UPT SMA NEGERI 12 BANYUASIN}{\rtlch \fcs1 \af0 \afs24 \
ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \
trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs2 \ltrch \fcs0 \fs2 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \
hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\
trowd \trql \trgaph0 \trrh341 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \tpvpg \
tphpg \tposx709 \tposy933 \tabsnoovrlp1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \
cellx10480 \row }\trowd \trql \trgaph0
\trrh280 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \tpvpg \tphpg \tposx709 \
tposy933 \tabsnoovrlp1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \
trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth880 \clftsWidth3 \
cellx880 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth380 \clftsWidth3 \cellx1260 \clvertalb \
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \
cltxlrtb \clwWidth320 \clftsWidth3 \cellx1580 \clvertalb \clbrdrl \brdrnone \
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth280 \
clwWidth20 \clftsWidth3 \cellx10480 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \
sl240 \slmult1 \nowidctlpar \lin0 \rin0 \phmrg \pvpara \posx709 \posy933 \intbl \
itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \
\tdfrmtxtRight180 \trftsWidth1 \trftsWidthB3
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qc \
li0 \ri4358 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin4358 \phmrg \
pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \
fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \
b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \charscalex98 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Akreditasi A}{\rtlch \
fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \
af5 \loch \f6 \charscalex98 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
nowidctlpar \lin0 \rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1
\af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch
\af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \trowd \trql \
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs2 \
ltrch \fcs0 \fs2 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \
lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0
\rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh280 \trleft0 \tdfrmtxtLeft180 \
tdfrmtxtRight180 \tpvpg \tphpg \tposx709 \tposy933 \tabsnoovrlp1 \trftsWidth1 \
trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \
cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvertalb \clbrdrl \brdrnone \clbrdrr
\brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth380 \clftsWidth3
\cellx1260 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \cellx10480 \row }\trowd \trql \trgaph0
cellx10480 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \
fi318 \li-318 \ri2338 \lisb0 \sa0 \lisa0 \sl-187 \slmult0 \nowidctlpar \lin-318 \
rin2338 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \trowd \trql \trgaph0 \
trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \trftsWidth1 \trftsWidthB3 \trftsWidthA3
\trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af7 \afs22 \ltrch \
langnp1035 \langfe1033 \langfenp1033 \alang1025 Jalan KH Sulaiman Kelurahan
Kedondong Raye Kabupaten Banyuasin }{\rtlch \fcs1 \af7 \afs22 \ltrch \fcs0 \fs18 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af7
\loch \f7 \lang1035 \langnp1035 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
plain \qc \fi318 \li-318 \ri2338 \lisb0 \sa0 \lisa0 \sl-187 \slmult0 \nowidctlpar \
lin-318 \rin2338 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \
lang1035 \langnp1035 \langfe1033 \langfenp1033 \alang1025 Sumatera Selatan Kode Pos
30911}{\rtlch \fcs1 \af7 \afs22 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \dbch \
af0 \hich \af5 \loch \f7 \lang1035 \langnp1035 \langfe1033 \langfenp1033 \alang1025
\cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0
\rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
\trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs2 \ltrch \fcs0 \
fs2 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \
clwWidth20 \clftsWidth3 \cellx10480 \row }\trowd \trql \trgaph0 \trrh385 \trleft0 \
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs
\brdrw20 \cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvertalb \clbrdrl \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth320 \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx1860 \
brdrs \brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3 \cellx2160 \clvertalb \clbrdrl \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \cellx10480 \pard \
plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qj \fi567 \li-1447 \ri0 \
lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin-
1447 \rin0 \tql \tx1980 \tql \tx4680 \phmrg \pvpara \posx709 \posy933 \intbl \itap1
\outlinelevel0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
\loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
hich \af7 \loch \f7 \lang1053 \langnp1053 \langfe1033 \langfenp1033 \alang1025
websiteWeb Website : www.smaplusn2ba3.sch.id email:
smaplusn2banyuasin@gmail.com}{\rtlch \fcs1 \af7 \afs20 \ltrch \fcs0 \fs20 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \
cell }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033
\alang1025 {\trowd \trql \trgaph0 \trrh385 \trleft0 \tdfrmtxtLeft180 \
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \
\brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth380 \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth8020 \clftsWidth3 \
clbrdrb \brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \cellx10480 \row }\trowd \trql
\trgaph0 \trrh20 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \tpvpg \tphpg \
tposx709 \tposy933 \tabsnoovrlp1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-20 \slmult0 \nowidctlpar \lin0 \rin0 \
lisb0 \sa0 \lisa0 \sl-20 \slmult0 \nowidctlpar \lin0 \rin0 \phmrg \pvpara \
langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-20 \
fcs1 \af0 \afs2 \ltrch \fcs0 \fs2 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \
loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb
\clwWidth320 \clftsWidth3 \cellx1580 \clvertalb \clbrdrl \brdrnone \clbrdrr \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth7440 \clftsWidth3
clbrdrb \brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \cellx10480 \pard \plain \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qc \li0 \ri2918 \lisb0 \
sa0 \lisa0 \sl-339 \slmult0 \nowidctlpar \lin0 \rin2918 \phmrg \pvpara \posx709 \
posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
\ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 \trowd \trql \trgaph0 \trleft0 \tdfrmtxtLeft180 \
trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \
alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \charscalex99 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 DATA PRIBADI PESERTA DIDIK BARU}{\
rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \
cltxlrtb \clwWidth280 \clftsWidth3
langfenp1033 \alang1025 \cell }\pard \plain \qc \li0 \ri2898 \lisb0 \sa0 \lisa0 \
sl-339 \slmult0 \nowidctlpar \lin0 \rin2898 \phmrg \pvpara \posx709 \posy933 \intbl
\itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \
langfenp1033 \alang1025 TAHUN PELAJARAN 20}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \
b1 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \charscalex99 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 2}{\rtlch \fcs1 \af6 \
afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \
f6 \charscalex99 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 2 /
2023}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
\rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
\trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs2 \ltrch \fcs0 \
clbrdrb \brdrnone
\cltxlrtb \clwWidth320 \clftsWidth3 \cellx1580 \clvertalb \clbrdrl \brdrnone \
trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \
clftsWidth3 \cellx880 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth380 \clftsWidth3 \cellx1260
clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
\brdrnone \cltxlrtb \clwWidth8020 \clftsWidth3 \cellx10460 \clvertalb \clbrdrl \
sl-208 \slmult0 \nowidctlpar \lin360 \rin0 \phmrg \pvpara \posx709 \posy933 \
NIS}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
\cell }\pard \plain \qr \li0 \ri70 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar
\lin0 \rin70 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af0 \
cell }\pard \plain \li20 \ri0 \lisb0 \sa0 \lisa0 \sl-185 \slmult0 \nowidctlpar \
lin20 \rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22
\ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \
\trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af8 \afs16 \ltrch \
fcs0 \i1 \fs16 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 *) (diisi panitia)}{\rtlch \fcs1 \
af6 \afs29 \ltrch \fcs0 \b1 \fs29 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \
loch \f6 \charscalex99 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
alang1025 }{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \
brdrnone \cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvmgf \clvertalb \
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx2440 \clvmgf \clvertalb \
clftsWidth3 \cellx10480 \row }\trowd \trql \trgaph0 \trrh268 \trleft0 \
\clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvmrg \clvertalb
\clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \
cltxlrtb \clwWidth380 \clftsWidth3 \cellx1260 \clvertalb \clbrdrl \brdrs \brdrw20 \
clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
clwWidth320 \clftsWidth3 \cellx1580 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \
brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth280 \clftsWidth3 \
cellx1860 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone
\clbrdrb \brdrnone \cltxlrtb \clwWidth300 \clftsWidth3 \cellx2160 \clvertalb \
clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \
cltxlrtb \clwWidth280 \clftsWidth3 \cellx2440 \clvmrg \clvertalb \clbrdrl \brdrnone
\clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth8020 \
trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \
brdrnone \cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvmrg \clvertalb \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth20 \clftsWidth3 \cellx10480 \row }\
trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \
\clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \
clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth320 \clftsWidth3 \cellx1580 \clvertalb \
clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \
brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx1860 \clvertalb \clbrdrl \
brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \
clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033
trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 NISN}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri70 \lisb0 \sa0
\lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin70 \phmrg \pvpara \posx709 \
posy933 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfenp1033 \alang1025 \trowd \trql \trgaph0 \trleft0 \tdfrmtxtLeft180 \
langfenp1033 \alang1025 :}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
b1 \i1 \fs16 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 (WAJIB diisi oleh calon siswa)}{\
rtlch \fcs1 \af6 \afs29 \ltrch \fcs0 \b1 \fs29 \rtlch \alang1025 \ltrch \dbch \
langfenp1033 \alang1025 }{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \
trrh64 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \tpvpg \tphpg \tposx709 \
clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth320 \clftsWidth3 \cellx1580
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb
\brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx1860 \clvertalb \
clbrdrb \brdrnone \cltxlrtb \clwWidth880 \clftsWidth3 \cellx880 \clvmrg \
clftsWidth3 \cellx4160 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
slmult1 \nowidctlpar \lin0 \rin0 \phmrg \pvpara \posx709 \posy933 \intbl \itap1
\rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \
plain \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh104 \trleft0 \
trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \clbrdrl \brdrnone \
fcs1 \af0 \afs23 \ltrch \fcs0 \fs23 \rtlch \alang1025 \ltrch \dbch
cellx4160 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs
brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \
clftsWidth3 \cellx2440 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \
clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \
\clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3 \cellx3020 \
clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \
brdrw20
\clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \
cellx4160 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af8 \afs16 \ltrch \fcs0 \i1 \fs16 \rtlch \
langfe1033 \langfenp1033 \alang1025 NISN diisi berdasarkan NISN dari sekolah asal
(SMP/MTs)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
\cellx1260 \clvertalb \clbrdrl \brdrs \brdrw20
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\clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx4160 \clvmgf \
clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
\langfe1033 \langfenp1033 \alang1025
\cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \
clwWidth280 \clftsWidth3 \cellx4160 \clvmrg \clvertalb \clbrdrl \brdrnone \
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\cell }\pard \plain \qr \li0 \ri70 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar
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trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs11 \ltrch \fcs0 \fs11 \rtlch
\alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \
lisa0 \sl-185 \slmult0 \nowidctlpar \lin20 \rin0 \phmrg \pvpara \posx709 \posy933 \
{\rtlch \fcs1 \af8 \afs16 \ltrch \fcs0 \b1 \i1 \fs16 \rtlch \alang1025 \ltrch \dbch
alang1025 (Lihat di Kartu Keluarga)}{\rtlch
\fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \
brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \
\clbrdrb \brdrnone \cltxlrtb \clwWidth280 \clftsWidth3 \cellx5900 \clvmrg \
tdfrmtxtLeft180 \tdfrmtxtRight180 \trftsWidth1 \trftsWidthB3
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \
clvertalb \clbrdrl
\brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
clwWidth880 \clftsWidth3 \cellx880 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \
clftsWidth3 \cellx1260 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20
\clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth320 \clftsWidth3 \
clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \
tdfrmtxtRight180 \trftsWidth1 \trftsWidthB3
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\rtlch \fcs1 \af0 \afs5
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slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \
\clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3
\cellx3300 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \
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rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 {\rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
dbch \af0 \hich \af5 \loch \af5 \lang1024 \langnp1024 \langfe1024 \langfenp1024 \
alang1025 {\shp {\*\shpinst \shpleft9065 \shptop50 \shpright10584 \shpbottom1729 \
shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara \shpbyignore \shpwr3 \shpwrk0 \
shpfblwtxt0 \shpz3 \shplid1027 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv
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hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par
}\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-335 \slmult0 \nowidctlpar \lin0 \
alang1025 \par }\pard \plain \li40 \ri0 \lisb0 \sa0 \lisa0 \sl239 \slmult1 \
nowidctlpar \lin40 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \
\langfe1033 \langfenp1033 \alang1025 A. Keterangan Tentang Diri Siswa}{\rtlch \fcs1
\af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch
\f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl-156 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch
\fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5
\dbch
\af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0
qj \fi-392 \li740 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \
nooverflow \lin740 \rin0 \tql \tx740 \itap0 \ls1 \rtlch \fcs1 \af0 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \plain \rtlch \
fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \
af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 1.\
tab }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \dbch \
Nama Siswa }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 (HARUS DIISI SESUAI IJAZAH SD / SMP/AKTE
KELAHIRAN)}{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trrh225 \
trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \
trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
clwWidth20 \clftsWidth3 \cellx5320 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth20
\clftsWidth3 \cellx6180 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \
af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \
pard \plain \li60 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin60 \rin0
\intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 a. Nama Lengkap}{\rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li80
\ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin80 \rin0 \intbl \itap1 \
:}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \
nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs19 \ltrch \fcs0 \fs19 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1
\af0 \afs19 \ltrch \fcs0 \fs19 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \
alang1025 {\rtlch \fcs1 \af0 \afs2 \ltrch \fcs0 \fs2 \rtlch \alang1025 \ltrch \dbch
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \
trql \trgaph0 \trrh225 \trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
\brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li0 \ri0 \
langfe1033 \langfenp1033 \alang1025 b. Nama Panggilan}{\rtlch \fcs1 \af0 \afs24 \
afs22
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs24
li0 \ri0 \lisb0 \sa200 \lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \row }\trowd \trql \
trgaph0 \trrh60 \trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \
\clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth280
\clftsWidth3 \cellx4160 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
clwWidth280 \clftsWidth3 \cellx9060 \clvmgf \clvertalb \clbrdrl \brdrnone \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 2.}{\rtlch
\fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5
\loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
alang1025 Tempat dan Tanggal Lahir}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \
af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs5
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri10 \lisb0 \
sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin10 \intbl \itap1 \rtlch \fcs1 \
dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \
af5 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 -}{\
lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \
alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \alang1025 \ltrch
\dbch \af0 \hich \af5 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
alang1025 -}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
trql \trgaph0 \trrh60 \trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth240 \clftsWidth3 \cellx5300
brdrs \brdrw20 \cltxlrtb \clwWidth240 \clftsWidth3 \cellx10460 \clvertalb \
cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \row }\trowd \trql \trgaph0 \trrh236 \
trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth2580 \clftsWidth3 \cellx3260 \clvmrg
brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx9060 \clvmrg \clvertalb \
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \
\clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx10220 \clvertalb
\clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \
clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
\slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0
\intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5
\dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \
\clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth640 \clftsWidth3 \cellx680 \clvmgf \
clftsWidth3 \cellx10220 \clvertalb \clbrdrl
cellx10490 \pard \plain \li300 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar
\lin300 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 3.}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
\rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \
langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
nowidctlpar \lin20 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Laki-Laki}{\rtlch \fcs1 \af0 \afs24
Perempuan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
afs5 \ltrch \fcs0 \fs5 \rtlch
clwWidth20 \clftsWidth3 \cellx3880 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \
trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \
clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \
clcbpat1 \clwWidth20 \clftsWidth3 \cellx3880 \clvmrg \clvertalb \clbrdrl \
cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx5320 \clvmrg \clvertalb \
clwWidth0 \clftsWidth3 \cellx10490
\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0
itap1 \rtlch
\fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \
lisa0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \
alang1025 {\trowd \trql \trgaph0 \trrh236 \trleft40 \trftsWidth1 \trftsWidthB3 \
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \
cltxlrtb \clwWidth640 \clftsWidth3 \cellx680 \clvmrg \clvertalb \clbrdrl \
clwWidth2580 \clftsWidth3 \cellx3260 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr
\cellx3580 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \
brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx3880 \clvmrg \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \
clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li300
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 4.}
langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lisa0 \sl-219 \slmult0 \nowidctlpar \lin80 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch \fcs1 \
loch \f4 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 1.}{\rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \af0 \afs24 \
alang1025 \cell
}\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \
rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 2. Protestan 3. Katolik 4. Hindu}{\rtlch \fcs1
\f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
alang1025 5. Budha }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 **)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth2580 \clftsWidth3 \cellx3260 \clvmgf
alang1025 Kewarganegaraan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
afs22 \ltrch \fcs0 \fs22
\rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WNA}{\rtlch \fcs1 \af0 \
brdrnone \clbrdrb \brdrnone \cltxlrtb
cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx5320 \clvmrg \clvertalb \
lisa0 \sl240 \slmult1
\nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22
clvertalb \clbrdrl
sl240 \slmult1 \nowidctlpar \lin300 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 6.}{\rtlch \fcs1 \af0 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Anak
keberapa}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af0 \afs24 \
alang1025
afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \
Jumlah saudara kandung}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lisa0 \sl240 \slmult1 \nowidctlpar
\langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 orang}{\rtlch \fcs1 \af0 \afs24 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 (Jumlah Kakak + Adik)}{\rtlch \fcs1
brdrs \brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3
alang1025 Jumlah saudara tiri}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch
f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \
alang1025 orang}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \
nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch
\fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh317 \trleft40 \trftsWidth1 \
\brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth2580 \
intbl \itap1 \rtlch
\fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Jumlah
saudara angkat}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 orang}{\rtlch \fcs1 \
lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0
\afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \
cltxlrtb \clwWidth320 \clftsWidth3 \cellx5640 \clvmgf \clvertalb \clbrdrl \brdrnone
\cellx8200 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt
\brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth280 \clftsWidth3 \cellx8480 \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 10.}{\
langfe1033 \langfenp1033 \alang1025 Status dalam Keluarga}{\rtlch \fcs1 \af0 \afs24
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Anak
Kandung}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
alang1025 Anak Tiri}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Anak Angkat}{\rtlch \fcs1
rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch
\f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain
\li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \
cltxlrtb \clwWidth640 \clftsWidth3 \cellx680 \clvmgf \clvertalb \clbrdrl \
clwWidth2580 \clftsWidth3 \cellx3260 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr
trowd \trql \trgaph0 \trrh236 \trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \
af5 \loch \f0
clbrdrr \brdrnone
clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx3880 \
clcbpat1 \clwWidth20 \clftsWidth3 \cellx5320 \clvertalb \clbrdrl \brdrnone \clbrdrr
\brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
alang1025 11.}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 Anak yatim/piatu/yatim piatu}{\
langnp1033 \langfe1033 \langfenp1033 \alang1025 Yatim}{\rtlch \fcs1 \af0 \afs24 \
afs5 \ltrch \fcs0
\fs5 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \
alang1025 Piatu}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Yatim Piatu}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Orang Tua Lengkap}{\rtlch
brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx5320 \clvertalb \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth260
clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs
\brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3 \cellx8780 \clvmrg \clvertalb \clbrdrl
brdrnone \clbrdrb \brdrs
brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20
\cltxlrtb \clwWidth300 \clftsWidth3 \cellx8780 \clvmrg \clvertalb \clbrdrl \
cellx10490 \row }\trowd \trql \trgaph0 \trrh60 \trleft40 \trftsWidth1 \trftsWidthB3
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Bahasa sehari-hari di rumah}{\rtlch
alang1025 :}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
Indonesia}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Daerah
________________________________}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
afs2 \ltrch \fcs0 \fs2 \rtlch \alang1025 \ltrch \dbch \af0
\hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \
trrh60 \trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \
trpaddfb3 \trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \
Pihak yang bisa dihubungi}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Ayah}{\rtlch \fcs1 \af0 \
nowidctlpar
langfe1033 \langfenp1033 \alang1025 Ibu}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Wali Siswa}{\rtlch \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb
af5
\hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
Penanggung jawab biaya}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Ayah}{\rtlch \fcs1 \af0 \
langfe1033 \langfenp1033 \alang1025 Ibu}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Wali Siswa}{\rtlch \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Sendiri}{\rtlch \fcs1 \
langfe1033
\langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \
cellx10490 \row }\trowd \trql \trgaph0 \trrh476 \trleft40 \trftsWidth1 \
clvertalb \clbrdrl \brdrnone \clbrdrr
lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 B.
Keterangan Tempat Tinggal Calon Siswa}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033
\langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
clwWidth280 \clftsWidth3 \cellx4740 \clvertalb \clbrdrl \brdrnone \clbrdrr
cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li300 \ri0 \lisb0 \sa0 \
\ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin60 \rin0 \intbl \itap1 \
Alamat Lengkap}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1
\af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth260 \clftsWidth3
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
\alang1025 {\rtlch \fcs1 \af0 \afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \
afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5
\loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\
fcs1 \af0 \afs5
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 RT}{\rtlch \fcs1 \af0 \
alang1025 \cell }\pard \plain \li40 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 RW}{\rtlch \fcs1 \af0 \afs24 \ltrch
\fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \lang1033 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kode Pos}{\rtlch \fcs1 \
\af0 \hich
\af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs20
langfe1033
\brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \clftsWidth3 \cellx3880 \clvertalb \
nowidctlpar \lin60 \rin0 \intbl \itap1 \rtlch \fcs1 \af0
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Telepon /
Handphone}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
fcs0 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
charscalex99 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 e-mail}{\
sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin90 \intbl \itap1 \rtlch \fcs1 \
fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \
hich \af8 \loch \f8 \charscalex90 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
rtlch \alang1025 \ltrch \dbch
clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li300
rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 Alamat tersebut / Tinggal di}{\
langnp1033 \langfe1033 \langfenp1033 \alang1025 Tempat tinggal orangtua}{\rtlch \
charscalex99 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Menumpang
pada orang lain}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Asrama}{\rtlch \fcs1 \af0 \afs24 \
clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10490 \row }\trowd \
brdrs \brdrw20
brdrs \brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3 \cellx6480 \clvmrg \clvertalb \
trql \trgaph0 \trrh60
\trleft40 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \
alang1025
clftsWidth3 \cellx9340 \clvertalb \clbrdrl \brdrnone \clbrdrr
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \
\brdrs \brdrw20 \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \
lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin300 \rin0 \intbl \itap1 \
langfe1033 \langfenp1033 \alang1025 Jarak tempat tinggal ke sekolah }{\rtlch \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\
langnp1033 \langfe1033 \langfenp1033 \alang1025 km}{\rtlch \fcs1 \af0 \afs24 \ltrch
\alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
clwWidth2900 \clftsWidth3 \cellx3580 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \
brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \
brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth20 \clftsWidth3 \
cellx3880 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrs \
brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \clftsWidth3 \cellx4160 \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb
clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-
208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 C. Keterangan Kesehatan}{\rtlch \
rtlch \alang1025 \ltrch \loch \af5 \hich
\af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs24 \ltrch
pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
rtlch
\alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \
clftsWidth3 \cellx3580 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \
clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth280 \
brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrs \brdrw20 \
clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \
\brdrs \brdrw20 \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \
brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \clwWidth20 \
clwWidth0 \clftsWidth3 \cellx10490 \pard \plain \li300 \ri0 \lisb0 \sa0 \lisa0 \sl-
208 \slmult0 \nowidctlpar \lin300 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
\ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin60 \rin0 \intbl \itap1
Golongan Darah}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 A}{\rtlch \fcs1 \af0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 B}{\rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 AB}{\rtlch \fcs1 \af0 \
lisa0
brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20
clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \
\brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth580 \
clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \
clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs
brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clcbpat1 \
brdrw20 \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth300 \
\langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kelainan Jasmani}{\
lisa0
clwWidth320 \clftsWidth3 \cellx5640 \clvertalb
\clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \
langfe1033 \langfenp1033 \alang1025 Tinggi / Berat Badan}{\rtlch \fcs1 \af0 \
charscalex92 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 cm}{\
afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 kg}{\rtlch \fcs1 \af0 \afs24 \ltrch
cltxlrtb \clwWidth300 \clftsWidth3 \cellx6480 \clvertalb
\clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth300 \clftsWidth3 \cellx4460 \clvmrg \
af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5
\loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\
clftsWidth3 \cellx10490 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
alang1025 {\rtlch \fcs1 \af0 \afs19 \ltrch \fcs0 \fs19
alang1025 {\rtlch \fcs1 \af8 \afs13 \ltrch \fcs0 \b1 \i1 \fs13 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex98 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 Formulir PPDB UPT SMA Negeri 12 BanyuasinI
Tahun Pelajaran 2021/2022}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
alang1025 \sect }\sectd \sbknone \pgwsxn11900 \pghsxn16836 \marglsxn10640 \
pgbrdropt0 \sectdefaultcl \endnhere \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-
35 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \lisb0
\sa0 \lisa0 \sl239 \slmult1 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbkpage \
pgwsxn11900 \pghsxn16836 \marglsxn760 \margrsxn720 \margtsxn1110 \margbsxn458 \
guttersxn0 \headery720 \footery720 \pgbrdropt0 \sectdefaultcl \endnhere \trowd \
clwWidth0 \clftsWidth3 \cellx8360 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208
\slmult0 \nowidctlpar
\langfenp1033 \alang1025 {\*\bkmkstart page2}{\*\bkmkend page2}{\rtlch \fcs1 \af8 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 D. Keterangan
Pendidikan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
cellx8360 \pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \
langfe1033 \langfenp1033 \alang1025 21.}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tanggal diterima}{\
cell }\pard \plain \qr \li0 \ri10 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \
li120 \ri0 \lisb0
\sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin120 \rin0 \intbl \itap1 \rtlch \fcs1
\af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \
loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
_____________________ (diisi oleh panitia)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
clwWidth0 \clftsWidth3 \cellx8360 \pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \
sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \
Pendidikan Sebelumnya}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lisa0 \sl240
brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx8360 \pard \plain \li0 \ri0 \lisb0
\sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
pard \plain \li60 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin60 \
langfe1033 \langfenp1033 \alang1025 a. Lulusan dari SMP/MTs}{\rtlch \fcs1 \af0 \
li0 \ri10 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin10 \intbl \
nowidctlpar \lin120 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22
langfe1033 \langfenp1033 \alang1025 _____________________________________}{\rtlch \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx8360 \row }\trowd \trql \trgaph0 \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth640 \clftsWidth3 \cellx640 \clvmgf \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 b. Nomor & tanggal Ijazah
}{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \fs18 \rtlch \alang1025 \ltrch \dbch \
*)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0
alang1025 _____________________ Tanggal}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri210 \lisb0 \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1
hich \af5 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 -}{\
hich \af5 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 -}{\
brdrnone \clbrdrt \brdrnone
\clbrdrb \brdrnone \cltxlrtb \clwWidth2540 \clftsWidth3 \cellx3180 \clvmgf \
brdrnone \cltxlrtb \clwWidth280 \clftsWidth3 \cellx3460 \clvmgf \clvertalb \clbrdrl
clftsWidth3 \cellx8360 \row }\trowd \trql \trgaph0 \trrh236 \trleft0 \trftsWidth1 \
\cellx3460 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
\cellx3180 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
\brdrnone \cltxlrtb \clwWidth2820 \clftsWidth3 \cellx6280 \clvmrg \clvertalb \
clbrdrt
langfe1033 \langfenp1033 \alang1025 c. Lama Belajar di SMP/MTs}{\rtlch \fcs1 \af0 \
langfe1033 \langfenp1033 \alang1025 ________ tahun}{\rtlch \fcs1 \af0 \afs24 \ltrch
clwWidth180
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx8360 \
row }\trowd \trql \trgaph0 \trrh124 \trleft0 \trftsWidth1 \trftsWidthB3 \
\cellx3180 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
\brdrnone \cltxlrtb \clwWidth2820 \clftsWidth3 \cellx6280 \clvmgf \clvertalb \
langfe1033 \langfenp1033 \alang1025 d. Nomor & tanggal SKHUN }{\rtlch \fcs1 \af8 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 *)}{\rtlch \fcs1 \af0
qr \li0 \ri10 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin10 \
langfe1033 \langfenp1033 \alang1025 _____________________ Tanggal}{\rtlch \fcs1 \
plain \qr \li0 \ri210 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \
rin210 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025 \cell }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \
langfe1033 \langfenp1033 \alang1025 -}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
brdrnone \cltxlrtb \clwWidth280 \clftsWidth3 \cellx8160
\clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrs \
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langfe1033 \langfenp1033 \alang1025 1. }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 2. Protestan 3. Katolik}
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 4. Hindu}{\rtlch \fcs1 \
alang1025 5. Budha}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
fcs0 \b1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
charscalex90 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 **)}{\rtlch
cltxlrtb \clwWidth1160
cellx10450 \pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WNA}{\rtlch \fcs1 \af0 \
nowidctlpar
itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22
clwWidth0 \clftsWidth3 \cellx10450
\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Pendidikan Terakhir}{\
cell }\pard \plain \qr \li0 \ri90 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard
Pekerjaan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
alang1025 \cell }\pard \plain \qr \li0 \ri90 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
itap1 \rtlch \fcs1 \af0 \afs22 \ltrch
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt
\langfe1033 \langfenp1033 \alang1025 TNI / POLRI}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri136
\lisb0 \sa0 \lisa0 \sl-162 \slmult0 \nowidctlpar \lin0 \rin136 \intbl \itap1 \rtlch
\fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5
\dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1
\af8 \afs14 \ltrch \fcs0 \b1 \fs14 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \
loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 **)}{\rtlch \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 PNS}{\rtlch \fcs1 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\rtlch \fcs1 \
alang1025 Lain-Lain}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \
cellx3220 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr
clftsWidth3 \cellx10180 \clvertalb \clbrdrl \brdrnone \clbrdrr
brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth1160 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O
Perwira Tinggi}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan
I}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Direksi}{\rtlch \fcs1 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Buruh Harian}{\rtlch \fcs1 \af0 \
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3
\cellx10450 \row }\trowd \trql \trgaph0 \trrh285 \trleft0 \trftsWidth1 \
brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth300 \
Perwira Menengah}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan
II}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Manager}{\rtlch \fcs1 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Buruh Bangunan}{\rtlch \fcs1 \af0
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Pertama}{\rtlch \fcs1 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan III}{\rtlch \fcs1 \af0 \
langfe1033 \langfenp1033 \alang1025 O Supervisor}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langfe1033 \langfenp1033 \alang1025 O Tani}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033
\langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh284 \trleft0 \
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Bintara}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan IV}{\rtlch \
langfe1033 \langfenp1033 \alang1025 O Staf}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
rtlch \fcs1 \af8 \afs14 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Pedagang}{\rtlch \fcs1 \af0 \
brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfe1033 \langfenp1033 \alang1025 O Tamtama}{\rtlch \fcs1 \af0 \afs24 \ltrch \
Pelaksana}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Wiraswasta}{\rtlch \
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Prajurit}{\rtlch \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0
\rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Honorer}{\rtlch \fcs1 \af0 \afs24
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb
\clwWidth300 \clftsWidth3 \cellx7880 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs
\brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth280 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Purnawirawan}{\rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Karyawan BUMN}{\rtlch \
clftsWidth3 \cellx5560 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt
dbch \af0 \hich \af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
\alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
Pensiunan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
clbrdrr \brdrnone
rtlch \alang1025 \ltrch \loch \af5 \hich
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Tukang Becak/Ojek }{\rtlch \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 **)}{\
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt
_______________}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \lisb0
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Gaji/Penghasilan Kotor
Rata-rata}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 per bulan (Ayah)}{\
\dbch
alang1025 Rp.}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
\alang1025 {\trowd \trql \trgaph0 \trrh272 \trleft0 \trftsWidth1 \trftsWidthB3 \
clftsWidth3 \cellx10450 \pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \
Alamat}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
alang1025 {\rtlch \fcs1
\af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \
af5 \loch \f0 \lang1033 \langnp1033 \langfe1033
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar
langnp1033 \langfe1033 \langfenp1033 \alang1025 RT}{\rtlch \fcs1 \af0 \afs24 \ltrch
charscalex85 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 RW}{\
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kode Pos}{\rtlch \fcs1 \
lisa0 \sl240 \slmult1
\clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch
langfe1033 \langfenp1033 \alang1025 Kabupaten / Kota}{\rtlch \fcs1 \af0 \afs24 \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0
\afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0
brdrnone \clbrdrb \brdrs \brdrw20
langfe1033 \langfenp1033 \alang1025 Nomor Telepon / Handphone}{\rtlch \fcs1 \af0 \
rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \
langfenp1033 \alang1025 e-mail}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5
trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth320 \clftsWidth3 \cellx6440
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Status Ayah}{\rtlch \fcs1
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kandung}{\rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tiri}{\rtlch \fcs1 \af0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Angkat}{\rtlch \fcs1 \af0 \afs24 \
itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 {\rtlch \fcs1 \af0 \afs20 \ltrch \fcs0 \fs20 \rtlch
clbrdrr
Status Nikah Ayah}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri90 \lisb0 \sa0 \lisa0 \sl-
\ltrch \fcs0 \b1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nikah}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Duda}{\rtlch \fcs1 \af0 \
li0 \ri0 \lisb0 \sa0
\lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvmrg \clvertalb \
\cellx3540 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr
afs22
plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Masih Hidup}{\rtlch \fcs1 \af0 \
Hidup}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
Meninggal, Tahun _____________}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
clbrdrb \brdrnone \cltxlrtb \clwWidth640 \clftsWidth3 \cellx640 \clvmgf
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell
cellx10450 \row }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-163 \slmult0 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \
lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \
\ltrch \fcs0 \b1 \i1 \fs13 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8
\charscalex98 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Formulir
PPDB UPT SMA Negeri 12 BanyuasinI Tahun Pelajaran 2021/2022}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbknone \
pgwsxn11900 \pghsxn16836 \marglsxn10640 \margrsxn740 \margtsxn1110 \margbsxn458 \
guttersxn0 \headery720 \footery720 \pgbrdropt0 \sectdefaultcl \endnhere \pard \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbkpage \pgwsxn11900
\pghsxn16836 \marglsxn760 \margrsxn720 \margtsxn1110 \margbsxn458 \guttersxn0 \
headery720 \footery720 \pgbrdropt0 \sectdefaultcl \endnhere \trowd \trql \trgaph0 \
clbrdrb \brdrnone \cltxlrtb
cellx10470 \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \
langfe1033 \langfenp1033 \alang1025 {\*\bkmkstart page3}{\*\bkmkend page3}{\rtlch \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 G.
Keterangan Tentang Ibu}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
alang1025 {\rtlch \fcs1 \af0 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025
clbrdrb \brdrnone \cltxlrtb \clwWidth40 \clftsWidth3 \cellx9080 \clvertalb \clbrdrl
langfe1033 \langfenp1033 \alang1025 Nama}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
\lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin90 \intbl \itap1 \rtlch \fcs1 \af0 \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl
\itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
clbrdrb
trpaddfr3 \clvmgf \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
cltxlrtb \clwWidth0 \clftsWidth3 \cellx10470 \pard \plain \qr \li0 \ri0 \lisb0 \sa0
Tempat dan Tanggal Lahir}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
dbch \af0 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \
ltrch \fcs0 \b1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
alang1025 \cell }\pard \plain \qc
\li0 \ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \
\dbch \af0 \hich \af5 \loch \f8 \charscalex90 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 -}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
clftsWidth3 \cellx7010 \clvertalb
\clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \
\clftsWidth3 \cellx7920 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \
langfe1033
cellx10200 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \
brdrnone
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 1. }{\rtlch \fcs1 \af8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \
dbch \af0 \hich \af8 \loch \f8 \charscalex97 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 2. Protestan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 3.
Katolik}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
langfenp1033 \alang1025 \cell }\pard \plain \qc \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-
208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch
afs22 \ltrch
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch
\afs8 \ltrch \fcs0 \fs8 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0 \
rtlch \alang1025 \ltrch \dbch \af0 \hich
clbrdrl \brdrs \brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \
clwWidth0 \clftsWidth3 \cellx10470 \pard \plain \qr \li0 \ri0 \lisb0
\sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \fcs1 \af0 \afs24 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WNI}
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri120 \lisb0 \sa0
\lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin120 \intbl \itap1 \rtlch \fcs1 \
af5 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 -}{\
langfe1033 \langfenp1033 \alang1025 WNA}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt
langfe1033 \langfenp1033 \alang1025 Pendidikan Terakhir}{\rtlch \fcs1 \af0 \afs24 \
alang1025 \cell }\pard \plain \li0 \ri0
\lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \
brdrnone
langfe1033 \langfenp1033 \alang1025 Pekerjaan}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \
ri90 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin90 \intbl \itap1 \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
\brdrs \brdrw20 \cltxlrtb \clwWidth420 \clftsWidth3 \cellx5000 \clvertalb \clbrdrl
alang1025 TNI / POLRI}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri137 \lisb0 \sa0
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 **)}{\rtlch \fcs1 \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl
langnp1033 \langfe1033 \langfenp1033 \alang1025 PNS}{\rtlch \fcs1 \af0 \afs24 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\rtlch \fcs1 \
\langfe1033 \langfenp1033 \alang1025 Lain-Lain}{\rtlch \fcs1 \af0 \afs24 \ltrch \
clbrdrl \brdrnone \clbrdrr
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Tinggi}{\
Golongan I}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Direksi}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Buruh Harian}{\rtlch \
brdrnone \cltxlrtb \clwWidth380 \clftsWidth3
\cellx3540 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Menengah}{\
Golongan II}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Manager}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Buruh Bangunan}{\
\brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \
cellx7890 \clvertalb \clbrdrl \brdrnone \clbrdrr
Perwira Pertama}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 O Golongan III}{\rtlch \fcs1 \af0 \afs24 \ltrch
alang1025 O Supervisor}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Tani}{\rtlch \fcs1 \af0 \afs24 \
langfe1033 \langfenp1033 \alang1025 \cell
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Bintara}{\rtlch \fcs1 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs22 \ltrch
langfe1033 \langfenp1033 \alang1025 O Golongan IV}{\rtlch \fcs1 \af0 \afs24 \
langfe1033 \langfenp1033 \alang1025 O Staf}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Pedagang}{\rtlch \fcs1 \af0 \
cltxlrtb \clwWidth1040 \clftsWidth3 \cellx4580 \clvertalb \clbrdrl \brdrnone
\clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Tamtama}{\rtlch \fcs1 \
alang1025 O Pelaksana}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich
\loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Wiraswasta}
clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10470 \pard \plain \li0 \
ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \
Prajurit}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
Honorer}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Purnawirawan}{\rtlch \fcs1 \af0 \
itap1 \rtlch \fcs1 \af0
Karyawan BUMN}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
clvertalb
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Pensiunan}{\rtlch \fcs1
brdrnone \cltxlrtb \clwWidth300 \clftsWidth3
langfe1033 \langfenp1033 \alang1025
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Tukang Becak/Ojek }{\
**)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
clftsWidth3
li0 \ri0
\lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 O }{\rtlch \fcs1 \af8 \afs14 \ltrch
\fcs0 \b1 \i1 \fs14 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 TIDAK BEKERJA}{\rtlch \
alang1025 \cell }\pard \plain \li0 \ri0 \lisb0
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone
Gaji/Penghasilan Kotor Rata-rata}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0
cellx10470 \row }\trowd \trql
\trgaph0 \trrh272 \trleft0 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 per bulan (Ibu)}{\rtlch \
pard \plain \qr \li0 \ri90 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Rp.}{\rtlch \fcs1 \
afs23 \ltrch \fcs0 \fs23 \rtlch \alang1025 \ltrch \dbch \af0
brdrnone \cltxlrtb \clwWidth40 \clftsWidth3 \cellx9080 \clvertalb
langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
clbrdrr
cltxlrtb \clwWidth0 \clftsWidth3 \cellx10470 \row }\pard \plain \li0 \ri0 \lisb0 \
sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0
\afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0
clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs
clbrdrb \brdrnone \cltxlrtb \clwWidth160 \clftsWidth3 \cellx4580 \clvmgf \clvertalb
langnp1033 \langfe1033 \langfenp1033 \alang1025 RT}{\rtlch \fcs1 \af0 \afs24 \ltrch
charscalex85 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 RW}{\
cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kode Pos}{\rtlch \fcs1 \af0 \
\clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl
Kabupaten / Kota}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \qr \li0 \ri90 \lisb0 \sa0 \lisa0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
:}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0
afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af5 \loch \f0
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20
Nomor Telepon / Handphone}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
afs18 \ltrch \fcs0 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 e-mail}{\rtlch \
langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \rtlch
\alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033
\langfenp1033 \alang1025 :}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
clwWidth420
clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth260 \clftsWidth3 \cellx5290 \clvmgf \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Status Ibu}{\rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kandung}{\rtlch \fcs1 \af0 \afs24 \
Tiri}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Angkat}{\rtlch \fcs1 \af0 \afs24 \
rtlch \alang1025 \ltrch \loch
\af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
clwWidth280 \clftsWidth3 \cellx9040 \clvertalb \clbrdrl \brdrnone
lisa0 \sl240
langfe1033 \langfenp1033 \alang1025 Status Nikah Ibu}{\rtlch \fcs1 \af0 \afs24 \
af5
Nikah}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Janda}{\rtlch \fcs1 \af0 \afs24 \
af5 \hich \af5 \dbch \af0
clbrdrl \brdrnone
\clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Masih Hidup}{\rtlch \fcs1
Hidup}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
langnp1033 \langfe1033 \langfenp1033
alang1025 Meninggal, Tahun _____________}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
cellx9080 \clvertalb \clbrdrl \brdrnone \clbrdrr
\brdrnone \cltxlrtb \clwWidth380 \clftsWidth3 \cellx3540 \clvertalb \clbrdrl \brdrs
\brdrw20 \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 H.
Keterangan Tentang Wali (DIISI JIKA SISWA TINGGAL BERSAMA WALI)}{\rtlch \fcs1 \
rtlch
alang1025
langfenp1033 \alang1025 Nama}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
nowidctlpar \lin0 \rin0 \intbl
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Laki-laki}{\rtlch \fcs1 \af0 \afs24
Perempuan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
brdrnone
rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033
\ri0
\lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin60 \rin0 \intbl \itap1 \
Tempat dan Tanggal Lahir}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar
langfenp1033 \alang1025 -}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone
\clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs20 \ltrch \fcs0 \fs20
brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth300 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af0 \afs24 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 1. Islam}{\rtlch \fcs1 \af0 \
langfenp1033 \alang1025 2. Protestan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 3.
Katolik}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
langfenp1033 \alang1025 \cell }\pard \plain \qc \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
dbch \af0 \hich \af5 \loch \f0 \lang1033
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \
langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0
\b1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af0 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WNA}
\af0 \hich \af5 \loch \f0 \lang1033
brdrnone
rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033
Pendidikan Terakhir}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
langfe1033 \langfenp1033 \alang1025 _________________________}{\rtlch \fcs1 \af0 \
lisa0 \sl276
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \
Pekerjaan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
trleft0 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3
\trpaddfr3 \clvmrg \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 TNI / POLRI}{\rtlch \
pard \plain \qr \li0 \ri137 \lisb0 \sa0 \lisa0 \sl-162 \slmult0 \nowidctlpar \
PNS}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs14 \ltrch \fcs0
\b1 \fs14 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Lain-Lain}{\rtlch \fcs1 \af0 \afs24
af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033
af5 \hich \af5 \dbch
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Tinggi}{\rtlch \fcs1 \af0
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan I}{\rtlch \
langfe1033 \langfenp1033 \alang1025 O Direksi}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langfe1033 \langfenp1033 \alang1025 O Buruh Harian}{\rtlch \fcs1 \af0 \afs24 \ltrch
intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Menengah}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan II}{\rtlch \
langfe1033 \langfenp1033 \alang1025 O Manager}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langfe1033 \langfenp1033 \alang1025 O Buruh Bangunan}{\rtlch \fcs1 \af0 \afs24 \
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Perwira Pertama}{\rtlch \fcs1 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Golongan III}{\rtlch \
langfe1033 \langfenp1033 \alang1025 O Supervisor}{\rtlch \fcs1 \af0 \afs24 \ltrch \
langfe1033 \langfenp1033 \alang1025 O Tani}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
clwWidth20 \clftsWidth3
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Bintara}{\rtlch \fcs1 \af0 \afs24
Golongan IV}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Staf}{\rtlch \fcs1 \af0
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Pedagang}{\rtlch
rtlch \alang1025 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Tamtama}{\rtlch \fcs1 \af0 \afs24
Pelaksana}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Wiraswasta}{\rtlch \
clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O Prajurit}{\rtlch \
afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Honorer}{\rtlch \fcs1 \af0 \afs24
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Purnawirawan}{\rtlch \fcs1 \af0 \
nowidctlpar \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Karyawan BUMN}{\rtlch \fcs1 \
af0 \lang1033 \langnp1033 \langfe1033
langnp1033 \langfe1033 \langfenp1033 \alang1025 O Pensiunan}{\rtlch \fcs1 \af0 \
rtlch \alang1025
fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
Tukang Becak/Ojek }{\rtlch \fcs1 \af8 \afs14 \ltrch \fcs0 \b1 \fs14 \rtlch \
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0
\rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \
rtlch \alang1025 \ltrch \dbch
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 O _______________}{\rtlch
brdrnone \clbrdrr
rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0
nowidctlpar \lin0 \rin0
i1 \fs13 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex98 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Formulir PPDB UPT SMA
Negeri 12 Banyuasin Tahun Pelajaran 2022/2023}{\rtlch \fcs1 \af0 \afs24 \ltrch \
cellx10470 \row }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbknone \pgwsxn11900 \
pghsxn16836 \marglsxn10640 \margrsxn740 \margtsxn1110 \margbsxn458 \guttersxn0 \
headery720 \footery720 \pgbrdropt0 \sectdefaultcl \endnhere \pard \plain \li0 \
ri0 \lisb0 \sa0 \lisa0 \sl-35 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1
\af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \
loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
alang1025 \sect }\sectd \sbkpage \pgwsxn11900 \pghsxn16836 \marglsxn760 \
pgbrdropt0 \sectdefaultcl \endnhere \trowd \trql \trgaph0 \trrh209 \trleft300 \
intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\*\bkmkstart page4}{\*\bkmkend
page4}{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \dbch \
langfenp1033 \alang1025 57.}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Gaji/Penghasilan Kotor
Rata-rata}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
clwWidth0 \clftsWidth3 \cellx10440 \row }\trowd \trql \trgaph0 \trrh364 \
\trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 per
bulan (Wali)}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \li140 \ri0 \lisb0 \sa0 \lisa0 \sl-
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : Rp.}{\rtlch \fcs1 \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrnone \cltxlrtb \
brdrnone \clbrdrt \brdrs \brdrw20 \clbrdrb \brdrnone \cltxlrtb \clwWidth840 \
brdrs \brdrw20 \clbrdrb \brdrnone \cltxlrtb \clwWidth600 \clftsWidth3 \cellx5860 \
alang1025
hich \af8 \loch \f8 \charscalex93 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch \fcs1 \af0 \afs24 \
brdrs \brdrw20 \cltxlrtb
clvertalb
fcs0 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex95 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 RT}{\rtlch \fcs1 \af0 \
langfe1033 \langfenp1033 \alang1025 RW}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kode
Pos}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
\brdrw20 \cltxlrtb \clwWidth600 \clftsWidth3 \cellx4420 \clvmgf \clvertalb \clbrdrl
\clvertalb \clbrdrl
brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt
\brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth860 \clftsWidth3 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex93 \lang1033 \
Kabupaten / Kota}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \li140 \ri0 \lisb0 \sa0 \lisa0 \sl-
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh328
\trleft300 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \
charscalex93 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 60.}{\rtlch
alang1025 Nomor Telepon / Handphone}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
fcs0 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Email:}{\rtlch \fcs1 \af0 \afs24 \
brdrnone \cltxlrtb \clcbpat1 \clwWidth280 \clftsWidth3 \cellx3820 \clvertalb \
cltxlrtb \clcbpat1 \clwWidth840 \clftsWidth3 \cellx5260 \clvertalb \clbrdrl \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth300 \clftsWidth3 \
\clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth300 \clftsWidth3 \cellx7020 \
clcbpat1 \clwWidth540 \clftsWidth3 \cellx10420 \clvertalb \clbrdrl \brdrnone \
alang1025 \cell }\pard \plain \li0
cellx3820 \clvertalb \clbrdrl \brdrs \brdrw20 \clbrdrr \brdrs \brdrw20 \clbrdrt \
clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth840 \clftsWidth3 \cellx5260 \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth300 \
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth300 \
clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clcbpat1 \clwWidth860 \
brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10440 \row }\pard \plain \li0 \ri0
\lisb0 \sa0 \lisa0 \sl-275 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \
af5 \loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\
ri0 \lisb0 \sa0 \lisa0 \sl-208 \slmult0 \nowidctlpar \lin0 \rin0 \intbl \itap1 \
I. Rincian Pengeluaran Keluarga per Bulan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd
brdrs \brdrw20 \cltxlrtb \clwWidth2240 \clftsWidth3 \cellx10420 \clvertalb \clbrdrl
alang1025 \cell }\pard \plain \li1580 \ri0 \lisb0 \sa0 \lisa0 \sl-208
\slmult0 \nowidctlpar \lin1580 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 Pengeluaran Perbulan}{\rtlch \
\langfe1033 \langfenp1033 \alang1025 Cicilan Per Bulan}{\rtlch \fcs1 \af0 \afs24 \
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain
\li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin0 \rin0 \intbl \
\brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Makan}{\rtlch \fcs1 \
alang1025 Rp}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langnp1033 \langfe1033 \langfenp1033 \alang1025
Cicilan .............................}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch \fcs1 \af0
li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1
\cellx6700 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone
\brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth2240
langfe1033 \langfenp1033 \alang1025 Rumah (cicilan / sewa)}{\rtlch \fcs1 \af0 \
trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone
clbrdrl
\langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Pakaian}{\rtlch \fcs1 \
\af0 \hich \af5 \loch \f0 \lang1033 \langnp1033
Kesehatan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
\langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
\alang1025 Cicilan .............................}{\rtlch \fcs1 \af0 \afs24 \
Rp}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Pendidikan (biaya
sekolah,}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
alang1025 \cell }\pard \plain \li0 \ri0 \lisb0 \sa200 \lisa0 \sl276
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \
brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt
\brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth2240 \clftsWidth3 \
Buku, transportasi, dll}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
charscalex76 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kartu
Kredit ......................}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
clftsWidth3 \cellx5280 \clvertalb \clbrdrl
\brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb
rtlch \fcs1 \af8 \afs18 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 Air (PAM)}{\rtlch \fcs1 \af0 \afs24
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kartu
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Listrik}{\rtlch \fcs1 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kartu
af0 \lang1033
langfe1033 \langfenp1033 \alang1025 \cell }\pard
Gas / minyak}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch \fcs1 \af0 \afs24 \ltrch
clbrdrr \brdrs \brdrw20 \clbrdrt
clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Telepon / HP}{\rtlch \
pard \plain \li120 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin120 \
langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 TOTAL 2}{\rtlch \
af0 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs5 \ltrch \
Transportasi}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
loch \af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
af5 \hich \af5
\dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \
\brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \clwWidth2240
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 TV Kabel}{\rtlch \fcs1 \
langfe1033 \langfenp1033 \alang1025 TOTAL 1 + TOTAL 2 =}{\rtlch \fcs1 \af0 \afs24
cellx5280
\clvertalb \clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb
cltxlrtb \clwWidth1120 \clftsWidth3
langfe1033 \langfenp1033 \alang1025 Asuransi}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch
alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af0 \afs5 \ltrch \
Hiburan}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
alang1025 {\rtlch
langfe1033 \langfenp1033 \alang1025 Pajak}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
alang1025 {\trowd
cellx10450 \row }\trowd \trql \trgaph0 \trrh260 \trleft0 \trftsWidth1
\trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb
\clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrnone \
langfe1033 \langfenp1033 \alang1025 BBM (Bensin)}{\rtlch \fcs1 \af0 \afs24 \ltrch \
af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Rp}{\rtlch
\clbrdrl \brdrnone \clbrdrr \brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \
langfe1033 \langfenp1033 \alang1025 Lainnya}{\rtlch \fcs1 \af0 \afs24 \ltrch \
af8 \loch \f8 \lang1033 \langnp1033
rtlch \alang1025 \ltrch \loch
\af5 \hich \af5 \dbch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
alang1025 TOTAL 1}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \loch \af5 \hich \af5 \dbch \af0
brdrs \brdrw20 \clbrdrt \brdrnone \clbrdrb \brdrs \brdrw20 \cltxlrtb \
cltxlrtb \clwWidth3660 \clftsWidth3 \cellx3940 \clvmgf
fcs0 \b1 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 *) diisi oleh panitia}{\
\langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \
langfe1033 \langfenp1033 \alang1025 **) lingkari salah satu}{\rtlch \fcs1 \af0 \
fcs0 \b1 \i1 \fs18 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Beri tanda \uc1 \u8730 ?
pada jawaban}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh236 \trleft0 \trftsWidth1 \
clbrdrb \brdrnone \cltxlrtb \clwWidth0 \clftsWidth3 \cellx10450 \row }\pard \
plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-264 \slmult0 \nowidctlpar \lin0 \rin0 \itap0
\rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li20 \ri0 \lisb0 \sa0 \
lisa0 \sl239 \slmult1 \nowidctlpar \lin20 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \
\ltrch \fcs0 \b1 \i1 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 PERNYATAAN :}{\rtlch \
pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-81 \slmult0 \nowidctlpar \lin0 \rin0 \
alang1025 \par }\pard \plain \qj \li0 \ri40 \lisb0 \sa0 \lisa0 \sl263 \slmult1 \
nowidctlpar \nooverflow \lin0 \rin40 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Saya yang bertanda tangan dibawah
ini menyatakan benar bahwa seluruh informasi yang tertera di formulir beserta
lampiran dokumen penunjang adalah benar adanya, apabila diperlukan oleh pihak SMA
Negeri Plus 2 Banyuasin III, dapat menghubungi instansi ataupun pihak-pihak terkait
kapanpun diperlukan guna memperoleh informasi tambahan mengenai kondisi siswa dan
apabila ditemukan adanya kebohongan atau pemalsuan dari formulir tersebut ataupun
lampiran dokumen - dokumen, maka Panitia SMA Negeri Plus 2 Banyuasin III }{\rtlch \
fcs1 \af8 \afs20 \ltrch \fcs0 \b1 \i1 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \
hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1
BERHAK}{\rtlch \fcs1 \af8 \afs20 \ltrch \fcs0 \fs20 \rtlch \alang1025 \ltrch \
alang1025 }{\rtlch \fcs1 \af8 \afs20 \ltrch \fcs0 \b1 \i1 \fs20 \rtlch \
langfe1033 \langfenp1033 \alang1025 \ul1 MEMBATALKAN}{\rtlch \fcs1 \af8 \afs20 \
ltrch \fcs0 \b1 \i1 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 }{\rtlch \fcs1 \
loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 anak tersebut
menjadi Calon Peserta didik SMA Negeri Plus 2 Banyuasin III}{\rtlch \fcs1 \af8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 .}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \
ri0 \lisb0 \sa0 \lisa0 \sl-200 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \
nowidctlpar \lin2720 \rin0 \tql \tx6720 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Mengetahui}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \
loch \f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Pangkanan Balai
, Februari 2023}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
\sl-48 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li2720 \ri0 \
lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin2720 \rin0 \tql \tx6720 \itap0 \
Orang Tua/ Wali Siswa}{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 Siswa Yang Bersangkutan}{\rtlch \fcs1 \af8 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \
ri0 \lisb0 \sa0 \lisa0 \sl-200 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \
\sl-215 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li2720 \ri0 \
lisb0 \sa0 \lisa0 \sl239 \slmult1 \nowidctlpar \lin2720 \rin0 \tql \tx6720 \itap0 \
____________________________}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 ____________________________}{\rtlch \fcs1 \
loch \f0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
af5 \hich \af5 \dbch \af0 \lang1033
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \
li2720 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \nowidctlpar \lin2720 \rin0 \tql \
tx6740 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs18 \ltrch \fcs0 \b1 \i1 \fs18 \rtlch
\alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \lang1033 \langnp1033 \langfe1033
\langfenp1033 \alang1025 Tanda Tangan & Nama Jelas}{\rtlch \fcs1 \af0 \afs24 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af8 \afs17 \
ltrch \fcs0 \b1 \i1 \fs17 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \
f8 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tanda Tangan & Nama
Jelas}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-147 \slmult0 \nowidctlpar \lin0
\rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \
\langfenp1033 \alang1025 {\rtlch \fcs1 \af8 \afs13 \ltrch \fcs0 \b1 \i1 \fs13 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex98 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Formulir PPDB SMA Negeri Plus 2
Banyuasin III Tahun Pelajaran 20}{\rtlch \fcs1 \af8 \afs13 \ltrch \fcs0 \b1 \i1 \
fs13 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \loch \f8 \charscalex98 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 2}{\rtlch \fcs1 \af8 \
afs13 \ltrch \fcs0 \b1 \i1 \fs13 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af8 \
loch \f8 \charscalex98 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
2/2023}{\rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \
alang1025 \sect }\sectd \sbknone \pgwsxn11900 \pghsxn16836 \marglsxn10640 \
pgbrdropt0 \sectdefaultcl \endnhere \pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl-
35 \slmult0 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs22 \ltrch \fcs0 \
\sa0 \lisa0 \sl239 \slmult1 \nowidctlpar \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }}

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{\rtf1 \ansi \ansicpg1252 \deff0 \stshfdbch2 \stshfloch0 \stshfhich0 \deflang1033 \

deflangfe1033 {\fonttbl {\f0 \froman \fcharset0 \fprq2 {\*\panose

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