Section 1 of 6
DATA PRIBADI
Formulir Daftar Ulang PPDB Tahap 2 (Jika kesulitan dapat menghubungi hotline SMAN 10 Depok 081513447633 (whatsapp only)
NO PENDAFTARAN
NO PENDAFTARAN
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JALUR PENDAFTARAN
JALUR PENDAFTARAN
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1.
ZONASI
2.
ABK
3.
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NAMA
NAMA
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JENIS KELAMIN
JENIS KELAMIN
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Time
1.
Laki-laki
2.
Perempuan
3.
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NISN
NISN
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NIK Peserta Didik
NIK Peserta Didik
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Time
Number
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NO KK
NO KK
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TEMPAT LAHIR
TEMPAT LAHIR
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TANGGAL LAHHIR (DD,MM,YYYY)
TANGGAL LAHHIR (DD,MM,YYYY)
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NO REGISTRASI AKTE LAHIR
NO REGISTRASI AKTE LAHIR
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AGAMA
AGAMA
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ALAMAT (JALAN, RT, RW, KEL, KEC, KOTA/KABUPATEN, KODE POS)
ALAMAT (JALAN, RT, RW, KEL, KEC, KOTA/KABUPATEN, KODE POS)
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TITIK KOORDINAT (LINTANG : -6.4XXXX, BUJUR: 106.7XXXX)
TITIK KOORDINAT (LINTANG : -6.4XXXX, BUJUR: 106.7XXXX)
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TEMPAT TINGGAL
TEMPAT TINGGAL
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Time
1.
Bersama orang tua
2.
Wali
3.
Asrama
4.
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MODA TRANSPORTASI
MODA TRANSPORTASI
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Date
Time
1.
Jalan kaki
2.
Angkutan umum/bus
3.
Mobil/bus antar jemput
4.
Ojek
5.
Sepeda
6.
Sepeda Motor
7.
Lainnya
8.
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ANAK KE-BERAPA (BERDASARKAN KK)
ANAK KE-BERAPA (BERDASARKAN KK)
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No WhatsApp Peserta Didik
No WhatsApp Peserta Didik
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Date
Time
Number
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Section 2 of 6
DATA ORANGTUA
NAMA AYAH
NAMA AYAH
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NIK AYAH
NIK AYAH
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NIK AYAH
NIK AYAH
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TANGGAL LAHIR
TANGGAL LAHIR
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PENDIDIKAN
PENDIDIKAN
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Date
Time
1.
SD / sederajat
2.
SMP / sederajat
3.
SMA / sederajat
4.
D1
5.
D2
6.
D3
7.
S1
8.
S2
9.
S3
10.
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PEKERJAAN
PEKERJAAN
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Date
Time
1.
Buruh
2.
Karyawan Swasta
3.
Lainnya
4.
Pedagang Besar
5.
Pedagang Kecil
6.
Pensiunan
7.
Petani
8.
Peternak
9.
PNS/TNI/Polri
10.
Sudah Meninggal
11.
Tidak bekerja
12.
Wiraswasta
13.
Wirausaha
14.
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PENGHASILAN
PENGHASILAN
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Date
Time
1.
Kurang dari Rp. 500,000
2.
Rp. 500,000 - Rp. 999,999
3.
Rp. 1,000,000 - Rp. 1,999,999
4.
Rp. 2,000,000 - Rp. 4,999,999
5.
Rp. 5,000,000 - Rp. 20,000,000
6.
Lebih dari Rp. 20,000,000
7.
Tidak Berpenghasilan
8.
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No WhatsApp/Bapak
No WhatsApp/Bapak
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Date
Time
Number
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NAMA IBU
NAMA IBU
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NIK IBU
NIK IBU
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TAHUN LAHIR
TAHUN LAHIR
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PENDIDIKAN
PENDIDIKAN
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Date
Time
1.
SD / sederajat
2.
SMP / sederajat
3.
SMA / sederajat
4.
D1
5.
D2
6.
D3
7.
S1
8.
S2
9.
S3
10.
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PEKERJAAN
PEKERJAAN
Question Type
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Date
Time
1.
Buruh
2.
Karyawan Swasta
3.
Lainnya
4.
Pedagang Besar
5.
Pedagang Kecil
6.
Pensiunan
7.
Petani
8.
Peternak
9.
PNS/TNI/Polri
10.
Sudah Meninggal
11.
Tidak bekerja
12.
Wiraswasta
13.
Wirausaha
14.
Add option
…
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PENGHASILAN
PENGHASILAN
Question Type
Short answer
Paragraph
Multiple choice
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Multiple choice grid
Checkbox grid
Date
Time
1.
Kurang dari Rp. 500,000
2.
Rp. 500,000 - Rp. 999,999
3.
Rp. 1,000,000 - Rp. 1,999,999
4.
Rp. 2,000,000 - Rp. 4,999,999
5.
Rp. 5,000,000 - Rp. 20,000,000
6.
Lebih dari Rp. 20,000,000
7.
Tidak Berpenghasilan
8.
Add option
…
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No WhatsApp/Ibu
No WhatsApp/Ibu
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Date
Time
Number
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Section 3 of 6
DATA PERIODIK
TINGGI BADAN (CM)
TINGGI BADAN (CM)
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BERAT BADAN (CM)
BERAT BADAN (CM)
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LINGKAR KEPALA
LINGKAR KEPALA
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JARAK RUMAH KE SEKOLAH
JARAK RUMAH KE SEKOLAH
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JUMLAH SAUDARA KANDUNG
JUMLAH SAUDARA KANDUNG
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Section 4 of 6
PERANGKAT YANG DIMILIKI
Perangkat yang dimiliki
Perangkat Yang Dimiliki Calon Peserta Didik
Perangkat Yang Dimiliki Calon Peserta Didik
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Date
Time
Laptop/NoteBook
Komputer PC
Tablet/SmartPhone
Jaringan Internet Rumah
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add "Other"
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Section 5 of 6
Data Peminatan
PILIHAN/PEMINATAN ?
PILIHAN/PEMINATAN ?
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Peminatan Matematika dan Ilmu Pengetahuan Alam (MIPA)
Peminatan Ilmu Pengetahuan Sosial (IPS)
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Pilihan Pendalaman Minat dan/atau LintasMinat mata pelajaran, diantaranya (pilih 2 mata pelajaran)
Pilihan Pendalaman Minat dan/atau LintasMinat mata pelajaran, diantaranya (pilih 2 mata pelajaran)
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Date
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Matematika
Biologi
Fisika
Kimia
Geografi
Sejarah
Sosiologi
Ekonomi
Informatika
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or
add "Other"
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Section 6 of 6
UPLOAD DUKUMEN
Berkas Yang diupload scan dokumen ASLI
UPLOAD BUKTI PENDAFTARAN PESERTA DIDIK BARU (data yang di upload dengan format .pdf)
UPLOAD BUKTI PENDAFTARAN PESERTA DIDIK BARU (data yang di upload dengan format .pdf)
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Add file
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1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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Upload Lembar Pengumuman diterima di SMAN 10 Depok (data yang di upload dengan format .pdf)
Upload Lembar Pengumuman diterima di SMAN 10 Depok (data yang di upload dengan format .pdf)
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Date
Time
Add file
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Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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Upload Surat Pertanggung Jawaban Mutlak Orang Tua (data yang di upload dengan format .pdf)
Upload Surat Pertanggung Jawaban Mutlak Orang Tua (data yang di upload dengan format .pdf)
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Date
Time
Add file
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Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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Upload Pernyataan Orang Tua/Wali Calon Peserta Didik (data yang di upload dengan format .pdf)
Upload Pernyataan Orang Tua/Wali Calon Peserta Didik (data yang di upload dengan format .pdf)
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File upload
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Date
Time
Add file
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Allow only specific file types
Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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Upload Pernyataan Calon Peserta Didik (data yang di upload dengan format .pdf)
Upload Pernyataan Calon Peserta Didik (data yang di upload dengan format .pdf)
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Date
Time
Add file
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Allow only specific file types
Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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Answer key
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Upload Kartu Keluarga (data yang di upload dengan format .pdf)
Upload Kartu Keluarga (data yang di upload dengan format .pdf)
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Date
Time
Add file
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Allow only specific file types
Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
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