FORMULIR PENDAFTARAN CALON PENGURUS OSIS MASA BHAKTI 2014-2015 SMP JAKARTA 2

YAYASAN TAMAN PENDIDIKAN SITI SARI

SMP JAKARTA 2

Jl. Cempaka Baru Tengah No. 1 – 3 RT. 06/006 Jakarta Pusat 10640

Telp. (021) 4210272 email: smpjakarta2@gmail.com

FORMULIR PENDAFTARAN CALON PENGURUS OSIS

MASA BHAKTI 2014-2015

SMP JAKARTA 2

IDENTITAS DIRI

Nama Lengkap                : .................................................................................................................

Nama Panggilan              : .................................................................................................................

Agama                             : .................................................................................................................

Tempat Tanggal Lahir     : .................................................................................................................

Alamat Tempat Tinggal   : .................................................................................................................

Nomor Handphone         : .................................................................................................................

Email                               : .................................................................................................................

Hobi                                : .................................................................................................................

Motivasi Menjadi Pengurus OSIS : ..................................................................................................

........................................................................................................................................................................................................................................................................................................................

Kritik bagi Pengurus OSIS terdahulu : .............................................................................................

....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Saran bagi Pengurus OSIS yang baru : .............................................................................................

....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

IDENTITAS ORANG TUA/WALI MURID

Nama Ayah                     : .................................................................................................................

Pekerjaan                         : .................................................................................................................

Nomor Handphone         : .................................................................................................................

Nama Ibu                        : .................................................................................................................

Pekerjaan                         : .................................................................................................................

Nomor Handphone         : .................................................................................................................

Alamat Tempat Tinggal   : .................................................................................................................

            Dengan mengisi Formulir Pendaftaran Pengurus OSIS ini, maka saya secara sadar dan tanpa paksaan dari pihak manapun, serta atas sepengetahuan dan izin dari orang tua/wali murid untuk mengikuti Pendaftaran Pengurus OSIS Masa Bhakti 2014-2015.

Orang Tua/Wali Murid (..................................................)

Jakarta, ..................................... 2014 Calon Pengurus OSIS (..................................................)