Contoh Kartu Pribadi Siswa



PEMERINTAH KABUPATEN ………..
DINAS PENDIDIKAN PEMUDA DAN OLAH RAGA
SD NEGERI 012 NAUMBAI
ALAMAT: …………………………………………

KARTU PRIBADI SISWA
(STUDENT CUMMULATIVE RECORD)
A.      DATA IDENTITAS SISWA
1.       NAMA SISWA                                     
a.    Lengkap                                                               :...............................................................................
b.   Panggilan                                                              : ...............................................................................
2.       NIS/NISN                                                                                : ...............................................................................
3.       TEMPAT/TANGGAL LAHIR                                              : ...............................................................................
4.       JENIS KELAMIN                                                                  : ...............................................................................
5.       AGAMA                                                                                  : ...............................................................................
6.       KEWARGANEGARAAN                                                     : ...............................................................................
7.       ALAMAT & NO TLPN                                                         : ...............................................................................
8.       BERTEMPAT TINGGAL PADA                                         : ...............................................................................
9.       JARAK TEMPAT TINGGAL KE SEKOLAH                   : ...............................................................................
10.   BAHASA SEHARI-HARI                                                       : ...............................................................................
B.      PENDIDIKAN
1. SEBELUMNYA
a)      Asal murid                                                           : ...............................................................................
b)      Nama taman kanak-kanak                                : ...............................................................................
c)       Alamat                                                                 : ...............................................................................
d)      Tanggal & No. STTB                                          : ...............................................................................
1.       PINDAHAN DARI SEKOLAH LAIN
a)      Nama sekolah asal                                               : ...............................................................................
b)      Dari tingkat                                                          : ...............................................................................
2.       MASUK DI SEKOLAH INI
a)      Diterima tanggal                                                  : ...............................................................................
b)      Di tingkat                                                              : ...............................................................................
C.         KELUARGA
A.      KETERANGAN ORANG TUA/WALI MURID
1.       Nama
a)      Ayah                                                                 : ...............................................................................
b)      Ibu                                                                    : ...............................................................................
2.       Pendidikan tertinggi
a)      Ayah                                                                 : ...............................................................................
b)      Ibu                                                                    : ...............................................................................
3.       Pekerjaan                                                                 
a)      Ayah                                                                 : ...............................................................................
b)      Ibu                                                                    : ...............................................................................
4.       Wali murid (jika mempunyai)
a)      Nama                                                                : ...............................................................................
b)      Hubungan keluarga                                        : ...............................................................................
c)       Pendidikan tertinggi                                      : ...............................................................................
d)      Pekerjaan                                                         : ...............................................................................
B.      STATUS DALAM KELUARGA                             : ...............................................................................
C.      JUMLAH SAUDARA                        
a)      Kandung                                                           : ...............................................................................
b)      Tiri                                                                    : ...............................................................................
c)       Angkat                                                              : ...............................................................................
D.      SOSIAL
1.       HUBUNGAN DGN TEMAN                                   : ...............................................................................
2.       HUBUNGAN DGN GURU                                      : ...............................................................................
E.       PRESTASI BELAJAR
Tahun Pelajaran
2008/2009
2009/2010
2010/2011
2011 / 2012
... / ...
Tk/Kls
Tk/Kls
Tk/Kls
Tk/Kls
Tk/Kls
Smtr 1
Smtr 2
Smtr 1
Smtr 2
Smtr 1
Smtr 2
Smtr 1
Smtr 2
Smtr 1
Smtr2
NA
NR
NA
NR
NA
NR
NA
RA
NA
NR
1.       Agama










2.       Pkn










3.       B.Ind










4.       Mtk










5.       IPA










6.       IPS










7.       KTK










8.       Penjas










9.       B. Inggris










10.   Arab Melayu










11.   Jumlah Nilai










12.   Rata-rata










Lain-lain










1.       Kelakuan










2.       Kerajinan










3.       Kebersihan










Tidak Hadir :










Sakit










Izin










Lain-lain










Naik / Tidak Naik











F.          BAKAT                                                                            : ...............................................................................
G.        MINAT                                                                              : ...............................................................................
H.        KASEHATAN
a.       Berat badan                                                  : ...............................................................................
b.      Tinggi badan                                                 : ...............................................................................
c.      Golongan darah                                            : ...............................................................................
d. Penyakit yang pernah diderita                         : ...............................................................................
I.           KARIR                                                                            : ...............................................................................
J.           CITA-CITA                                                                    : ...............................................................................
K.         TES IQ                                                                             : ...............................................................................
L.          Bea siswa
          Jenis beasiswa:                                                                   : ...............................................................................
M.       Meninggalkan sekolah
1.       Tamat belajar
a.       Tahun tamat                                                 :.....................                     No. STTB    :.........................
b.      M elanjutkan ke sekolah                              :.....................                      di                 :.........................
2.       Pindah sekolah
Dari tingkat                                                                  : ...............................................................................
a.       Ke sekolah                                                     : ...............................................................................
b.      Ke tingkat                                                      : ...............................................................................
c.       Tanggal                                                          : ...............................................................................
3.       Keluar sekolah
a.       Tanggal                                                          : ...............................................................................
b.      Alasan                                                             : ...............................................................................
N.        Lain-lain
Catatan Penting                                                                   : ...............................................................................

                      

Comments

Popular posts from this blog

Contoh Perpindahan Panas (Kalor) Dalam Kehidupan Sehari-hari