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Form Pendaftaran Santri Baru (SMP)
Isi formulir pendaftaran sesuai dengan data yang sebenarnyanapabila mengalami kesulitan dalam mengisi formulir harap menghubungi cantact berikut HP/WA: 08174740001
* Indicates required question
Nama Siswa (Sesuai Ijazah)
*
Your answer
Jenis Kelamin
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Laki-laki
Perempuan
Alamat Lengkap
*
Your answer
Tempat Lahir
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Your answer
Tanggal Lahir
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MM
/
DD
/
YYYY
Sekolah SMP/MTs Asal
*
Your answer
Nama Ayah
*
Your answer
Nama Ibu
*
Your answer
Nomor Telepon/ Hp
*
Your answer
Sekolah Pilihan
*
SMP Unggulan Pondok Modern Selamat
SMP SSN Pondok Modern Selamat
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