Formulir Pendaftaran Siswa Baru SMA PGRI Mojosari
Isilah data dengan lengkap dan benar sesuai identitas anda
Nama Siswa
First Name
Middle Name
Last Name
Tanggal lahir
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Month
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31
Day
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1921
1920
Year
Jenis Kelamin
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Male
Female
N/A
Alamat
Dusun/RT/RW *contoh : Tambakrejo/RT:10/RW:11
Kelurahan/Desa
Kecamatan
Kabupaten
Provinsi
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
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Cyprus
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Democratic Republic of the Congo
Denmark
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Dominican Republic
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Falkland Islands
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Kiribati
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Libya
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Madagascar
Malawi
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Maldives
Mali
Malta
Marshall Islands
Martinique
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Mayotte
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Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
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Slovenia
Solomon Islands
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Somaliland
South Africa
South Ossetia
South Sudan
Spain
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Sudan
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Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Negara
Alamat E-mail
Nomor Telepon Calon Siswa
-
Area Code
Phone Number
Nomor Telepon Orang Tua/Wali
-
Area Code
Phone Number
Asal Sekolah
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