buku identitas pengurus da aggota

BUKU IDENTITAS ANGGOTA

TAHUN  : ...............

         NAMA KIM                                                  : ........................................................................

DESA/KELURAHAN                                 : ........................................................................

KECAMATAN                                             : ........................................................................

KABUPATEN/KODYA/KOTA                 : ........................................................................

BUKU IDENTITAS ANGGOTA

PETUNJUK PENGISIAN

A.    UMUM

Data ini dipergunakan untuk :

1.      Membantu mengenal Identitas resmi

2.      Mempermudah mengenali tempat tinggal

3.      Membantu pencarian apabila terjadi hal hal yang tidak di inginkan

B.     TEKNIS PENGISIAN

Tahun Ajaran                   : cukup jelas

Nomor1                            : cukup jelas

Nomor2                            : cukup jelas

Nomor3                            : sesuai dengan akte kelahiran

Nomor4                            : anak dari ayah

Nomor5                            : cukup jelas

Nomor6                            : anak dari ayah dan

Nomor7.1                         : cukup jelas

Nomor7.2                         : cukup jelas

Nomor7.3                         : pendidikan tertinggi

Nomor7.4                         : cukup jelas               

Nomor7.5                         : cukup jelas

Nomor8.1                         : cukup jelas

Nomor8.2                         : cukup jelas

Nomor8.3                         : pendidikan tertinggi

Nomor8.4                         : cukup jelas

Nomor8.5                         : cukup jelas

Nomor9.1                         : cukup jelas

Nomor9.2                         : cukup jelas

Nomor9.3                         : pendidikan tertinggi

Nomor9.4                         : cukup jelas

Nomor9.5                         : cukup jelas

Nomor10                          : cukup jelas

Nomor11                          : cukup jelas

Nomor13                          : cukup jelas

Nomor13                          : cukup jelas

BUKU IDENTITAS ANGGOTA

1.      Nomor Urut                            : ........................................................................................

2.      Nama anggota                         : ........................................................................................

3.      Tempat tanggal lahir               : ........................................................................................

4.      Anak yang ke                          : ........................................................................................

5.      Jumlah Saudara kandung        : ........................................................................................

6.      Jumlah saudara Tiri                 : ........................................................................................

7.      Ayah

7.1.Nama                                : ........................................................................................

7.2.Umur /tgl.lahir                  : ........................................................................................

7.3.Pendidikan                       : ........................................................................................

7.4.Pekerjaan              : ........................................................................................

7.5.Alamat                 : ........................................................................................

8.      Ibu

8.1.Nama                                : ........................................................................................

8.2.Umur /tgl.lahir                  : ........................................................................................

8.3.Pendidikan                       : ........................................................................................

8.4.Pekerjaan              : ........................................................................................

8.5.Alamat                 : ........................................................................................

9.      Wali

9.1.Nama                                : ........................................................................................

9.2.Umur /tgl.lahir                  : ........................................................................................

9.3.Pendidikan                       : ........................................................................................

9.4.Pekerjaan              : ........................................................................................

9.5.Alamat                 : ........................................................................................

10.  Mulai jadi anggota                  : ........................................................................................

11.  Jabatan                                    : ........................................................................................

12.  Alamat lengkap                       : ........................................................................................

13.  Keterangan                              : ........................................................................................

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DATA IDENTITAS PENGURUS

Pas Foto

 

14.  Nomor Urut                            : ........................................................................................

15.  Nama anggota                         : ........................................................................................

16.  Tempat tanggal lahir               : ........................................................................................

17.  Anak yang ke                          : ........................................................................................

18.  Jumlah Saudara kandung        : ........................................................................................

19.  Jumlah saudara Tiri                 : ........................................................................................

20.  Ayah

20.1.      Nama                           : ........................................................................................

20.2.      Umur /tgl.lahir             : ........................................................................................

20.3.      Pendidikan                  : ........................................................................................

20.4.      Pekerjaan                     : ........................................................................................

20.5.      Alamat                        : ........................................................................................

21.  Ibu

21.1.      Nama                           : ........................................................................................

21.2.      Umur /tgl.lahir             : ........................................................................................

21.3.      Pendidikan                  : ........................................................................................

21.4.      Pekerjaan                     : ........................................................................................

21.5.      Alamat                        : ........................................................................................

                

22.  Mulai jadi anggota                  : ........................................................................................

23.  Jabatan                                    : ........................................................................................

24.  Alamat lengkap                       : ........................................................................................

25.  Keterangan                              : ........................................................................................

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