ppdb.sdmuhammadiyah03kreatif.sch.id
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https://ppdb.sdmuhammadiyah03kreatif.sch.id/
Submission: On December 24 via api from US — Scanned from US
Submission: On December 24 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
Name: form — POST https://forms.zohopublic.com/personal555/form/PPDB20222023SDMuhammadiyah03KreatifTangerangSelata/formperma/aeHCNRHcFNBVmw8hg7dcbtMZoXpsWzFUI0Ml8w38-8g/htmlRecords/submit
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value=""><!-- To Track referrals , place the referrer name within the " " in the above hidden input field -->
<input type="hidden" name="zf_redirect_url" value=""><!-- To redirect to a specific page after record submission , place the respective url within the " " in the above hidden input field -->
<input type="hidden" name="zc_gad" value=""><!-- If GCLID is enabled in Zoho CRM Integration, click details of AdWords Ads will be pushed to Zoho CRM -->
<div class="zf-templateWrapper"><!---------template Header Starts Here---------->
<ul class="zf-tempHeadBdr">
<li class="zf-tempHeadContBdr">
<h2 class="zf-frmTitle"><em>PPDB 2022/2023 SD Muhammadiyah 03 Kreatif Tangerang Selatan</em></h2>
<p class="zf-frmDesc">Jl. Pamulang 2 Benda Barat 11 Komp. Ritan RT 03/09 Kelurahan Pondok Benda Kecamatan Pamulang Kota Tangerang Selatan</p>
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<!---------template Container Starts Here---------->
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<ul>
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld"><img src="/personal555/downloadlogoperma?filepath=%2FPPDB20222023SDMuhammadiyah03KreatifTangerangSelata%2Fzeimage%2F1646709959231_baner.jpg" width="100%" style=""><br>
<div><br></div>
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</li><!---------Description Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">A.
KETERANGAN TENTANG DIRI SISWA/I</span> <br></div>
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<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!---------Name Starts Here---------->
<li class="zf-tempFrmWrapper zf-name zf-namemedium"><label class="zf-labelName"> Nama Lengkap <em class="zf-important">*</em>
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<div class="zf-clearBoth"></div>
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<p id="Name_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
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<div class="zf-clearBoth"></div>
</li><!---------Name Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nama Panggilan <em class="zf-important">*</em>
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<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
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<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Radio Starts Here---------->
<li class="zf-radio zf-tempFrmWrapper zf-sideBySide"><label class="zf-labelName">Jenis Kelamin <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<div class="zf-overflow">
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio_1" name="Radio" checktype="c1" value="Laki-Laki">
<label for="Radio_1" class="zf-radioChoice">Laki-Laki</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio_2" name="Radio" checktype="c1" value="Perempuan">
<label for="Radio_2" class="zf-radioChoice">Perempuan</label> </span>
<div class="zf-clearBoth"></div>
</div>
<p id="Radio_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Radio Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Tempat & Tanggal Lahir <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine1" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine1_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Agama <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine2" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine2_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Radio Starts Here---------->
<li class="zf-radio zf-tempFrmWrapper zf-sideBySide"><label class="zf-labelName">Status </label>
<div class="zf-tempContDiv">
<div class="zf-overflow">
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio1_1" name="Radio1" checktype="c1" value="Yatim">
<label for="Radio1_1" class="zf-radioChoice">Yatim</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio1_2" name="Radio1" checktype="c1" value="Piatu">
<label for="Radio1_2" class="zf-radioChoice">Piatu</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio1_3" name="Radio1" checktype="c1" value="Yatim Piatu">
<label for="Radio1_3" class="zf-radioChoice">Yatim Piatu</label> </span>
<div class="zf-clearBoth"></div>
</div>
<p id="Radio1_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Radio Ends Here---------->
<!---------Phone Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nomor Telepon dan Handphone <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv zf-phonefld">
<div class="zf-phwrapper zf-phNumber">
<span> <input type="text" compname="PhoneNumber" name="PhoneNumber_countrycode" maxlength="20" checktype="c7" value="" phoneformat="1" iscountrycodeenabled="false" fieldtype="11" id="international_PhoneNumber_countrycode"
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<label>Number</label> </span>
<div class="zf-clearBoth"></div>
</div>
<p id="PhoneNumber_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Phone Ends Here---------->
<!---------Email Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Email <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input fieldtype="9" type="text" maxlength="255" name="Email" checktype="c5" value="" placeholder=""></span>
<p id="Email_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Email Ends Here---------->
<!---------Number Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> NIK Nomor Induk Keluarga <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="Number" checktype="c2" value="" maxlength="18" placeholder=""></span>
<p id="Number_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Number Ends Here---------->
<!---------Number Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Anak ke- </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="Number1" checktype="c2" value="" maxlength="18" placeholder=""></span>
<p id="Number1_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Number Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Asal Sekolah </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine3" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine3_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Alamat Sekolah Asal </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine4" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine4_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!--Image Upload-->
<!---------Image Upload Starts Here---------->
<li class="zf-tempFrmWrapper"><label class="zf-labelName">Upload Foto <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<input type="file" accept="image/*" name="ImageUpload" checktype="c1" multiple="multiple">
<p id="ImageUpload_error" class="zf-errorMessage" style="display:none;">Choose any file for this field.</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Image Upload Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">B.
KETERANGAN TEMPAT TINGGAL</span> <br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!--address-->
<!---------Address Starts Here---------->
<li class="zf-tempFrmWrapper zf-address zf-addrlarge "><label class="zf-labelName"> Alamat Rumah (Sekarang) <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv zf-address">
<div class="zf-addrCont">
<span class="zf-addOne"> <input type="text" maxlength="255" name="Address_AddressLine1" checktype="c1" placeholder="">
<label>Alamat 1</label>
</span>
<span class="zf-addOne"> <input type="text" maxlength="255" name="Address_AddressLine2" checktype="c1" placeholder="">
<label>Alamat 2</label>
</span>
<span class="zf-flLeft zf-addtwo"> <input type="text" maxlength="255" name="Address_City" checktype="c1" placeholder="">
<label>Kota</label>
</span>
<span class="zf-flLeft zf-addtwo"> <input type="text" maxlength="255" name="Address_Region" checktype="c1" placeholder="">
<label>Kecamatan/Provinsi</label>
</span>
<span class="zf-flLeft zf-addtwo"> <input type="text" maxlength="255" name="Address_ZipCode" checktype="c1" placeholder="">
<label>Kode Pos / Zip Code</label>
</span>
<span class="zf-flLeft zf-addtwo"> <select class="zf-form-sBox" name="Address_Country" checktype="c1">
<option value="-Select-">-Select-</option>
<option>Åland Islands</option>
<option>Afghanistan</option>
<option>Akrotiri</option>
<option>Albania</option>
<option>Algeria</option>
<option>American Samoa</option>
<option>Andorra</option>
<option>Angola</option>
<option>Anguilla</option>
<option>Antarctica</option>
<option>Antigua and Barbuda</option>
<option>Argentina</option>
<option>Armenia</option>
<option>Aruba</option>
<option>Ashmore and Cartier Islands</option>
<option>Australia</option>
<option>Austria</option>
<option>Azerbaijan</option>
<option>Bahrain</option>
<option>Bangladesh</option>
<option>Barbados</option>
<option>Bassas Da India</option>
<option>Belarus</option>
<option>Belgium</option>
<option>Belize</option>
<option>Benin</option>
<option>Bermuda</option>
<option>Bhutan</option>
<option>Bolivia</option>
<option>Bosnia and Herzegovina</option>
<option>Botswana</option>
<option>Bouvet Island</option>
<option>Brazil</option>
<option>British Indian Ocean Territory</option>
<option>British Virgin Islands</option>
<option>Brunei</option>
<option>Bulgaria</option>
<option>Burkina Faso</option>
<option>Burma</option>
<option>Burundi</option>
<option>Cambodia</option>
<option>Cameroon</option>
<option>Canada</option>
<option>Cape Verde</option>
<option>Caribbean Netherlands</option>
<option>Cayman Islands</option>
<option>Central African Republic</option>
<option>Chad</option>
<option>Chile</option>
<option>China</option>
<option>Christmas Island</option>
<option>Clipperton Island</option>
<option>Cocos (Keeling) Islands</option>
<option>Colombia</option>
<option>Comoros</option>
<option>Cook Islands</option>
<option>Coral Sea Islands</option>
<option>Costa Rica</option>
<option>Cote D'Ivoire</option>
<option>Croatia</option>
<option>Cuba</option>
<option>Curaçao</option>
<option>Cyprus</option>
<option>Czech Republic</option>
<option>Democratic Republic of the Congo</option>
<option>Denmark</option>
<option>Dhekelia</option>
<option>Djibouti</option>
<option>Dominica</option>
<option>Dominican Republic</option>
<option>Ecuador</option>
<option>Egypt</option>
<option>El Salvador</option>
<option>Equatorial Guinea</option>
<option>Eritrea</option>
<option>Estonia</option>
<option>Ethiopia</option>
<option>Europa Island</option>
<option>Falkland Islands (Islas Malvinas)</option>
<option>Faroe Islands</option>
<option>Federated States of Micronesia</option>
<option>Fiji</option>
<option>Finland</option>
<option>France</option>
<option>French Guiana</option>
<option>French Polynesia</option>
<option>French Southern and Antarctic Lands</option>
<option>Gabon</option>
<option>Gaza Strip</option>
<option>Georgia</option>
<option>Germany</option>
<option>Ghana</option>
<option>Gibraltar</option>
<option>Glorioso Islands</option>
<option>Greece</option>
<option>Greenland</option>
<option>Grenada</option>
<option>Guadeloupe</option>
<option>Guam</option>
<option>Guatemala</option>
<option>Guernsey</option>
<option>Guinea</option>
<option>Guinea-bissau</option>
<option>Guyana</option>
<option>Haiti</option>
<option>Heard Island and Mcdonald Islands</option>
<option>Holy See (Vatican City)</option>
<option>Honduras</option>
<option>Hong Kong</option>
<option>Hungary</option>
<option>Iceland</option>
<option>India</option>
<option>Indonesia</option>
<option>Iran</option>
<option>Iraq</option>
<option>Ireland</option>
<option>Isle of Man</option>
<option>Israel</option>
<option>Italy</option>
<option>Jamaica</option>
<option>Jan Mayen</option>
<option>Japan</option>
<option>Jersey</option>
<option>Jordan</option>
<option>Juan De Nova Island</option>
<option>Kazakhstan</option>
<option>Kenya</option>
<option>Kiribati</option>
<option>Kosovo</option>
<option>Kuwait</option>
<option>Kyrgyzstan</option>
<option>Laos</option>
<option>Latvia</option>
<option>Lebanon</option>
<option>Lesotho</option>
<option>Liberia</option>
<option>Libya</option>
<option>Liechtenstein</option>
<option>Lithuania</option>
<option>Luxembourg</option>
<option>Macau</option>
<option>Macedonia</option>
<option>Madagascar</option>
<option>Malawi</option>
<option>Malaysia</option>
<option>Maldives</option>
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<option>Malta</option>
<option>Marshall Islands</option>
<option>Martinique</option>
<option>Mauritania</option>
<option>Mauritius</option>
<option>Mayotte</option>
<option>Mexico</option>
<option>Moldova</option>
<option>Monaco</option>
<option>Mongolia</option>
<option>Montenegro</option>
<option>Montserrat</option>
<option>Morocco</option>
<option>Mozambique</option>
<option>Myanmar</option>
<option>Namibia</option>
<option>Nauru</option>
<option>Navassa Island</option>
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<option>Netherlands</option>
<option>Netherlands Antilles</option>
<option>New Caledonia</option>
<option>New Zealand</option>
<option>Nicaragua</option>
<option>Niger</option>
<option>Nigeria</option>
<option>Niue</option>
<option>Norfolk Island</option>
<option>North Korea</option>
<option>Northern Mariana Islands</option>
<option>Norway</option>
<option>Oman</option>
<option>Pakistan</option>
<option>Palau</option>
<option>Palestine</option>
<option>Panama</option>
<option>Papua New Guinea</option>
<option>Paracel Islands</option>
<option>Paraguay</option>
<option>Peru</option>
<option>Philippines</option>
<option>Pitcairn Islands</option>
<option>Poland</option>
<option>Portugal</option>
<option>Puerto Rico</option>
<option>Qatar</option>
<option>Republic of the Congo</option>
<option>Reunion</option>
<option>Romania</option>
<option>Russia</option>
<option>Rwanda</option>
<option>Saint Barthélemy</option>
<option>Saint Helena</option>
<option>Saint Kitts and Nevis</option>
<option>Saint Lucia</option>
<option>Saint Martin</option>
<option>Saint Pierre and Miquelon</option>
<option>Saint Vincent and the Grenadines</option>
<option>Samoa</option>
<option>San Marino</option>
<option>Sao Tome and Principe</option>
<option>Saudi Arabia</option>
<option>Senegal</option>
<option>Serbia</option>
<option>Seychelles</option>
<option>Sierra Leone</option>
<option>Singapore</option>
<option>Sint Maarten</option>
<option>Slovakia</option>
<option>Slovenia</option>
<option>Solomon Islands</option>
<option>Somalia</option>
<option>South Africa</option>
<option>South Georgia and the South Sandwich Islands</option>
<option>South Korea</option>
<option>South Sudan</option>
<option>Spain</option>
<option>Spratly Islands</option>
<option>Sri Lanka</option>
<option>Sudan</option>
<option>Suriname</option>
<option>Svalbard</option>
<option>Swaziland</option>
<option>Sweden</option>
<option>Switzerland</option>
<option>Syria</option>
<option>Taiwan</option>
<option>Tajikistan</option>
<option>Tanzania</option>
<option>Thailand</option>
<option>The Bahamas</option>
<option>The Gambia</option>
<option>Timor-leste</option>
<option>Togo</option>
<option>Tokelau</option>
<option>Tonga</option>
<option>Trinidad and Tobago</option>
<option>Tromelin Island</option>
<option>Tunisia</option>
<option>Turkey</option>
<option>Turkmenistan</option>
<option>Turks and Caicos Islands</option>
<option>Tuvalu</option>
<option>Uganda</option>
<option>Ukraine</option>
<option>United Arab Emirates</option>
<option>United Kingdom</option>
<option>United States</option>
<option>Uruguay</option>
<option>Uzbekistan</option>
<option>Vanuatu</option>
<option>Venezuela</option>
<option>Vietnam</option>
<option>Virgin Islands</option>
<option>Wake Island</option>
<option>Wallis and Futuna</option>
<option>West Bank</option>
<option>Western Sahara</option>
<option>Yemen</option>
<option>Zambia</option>
<option>Zimbabwe</option>
</select>
<label>Kewarganegaraan</label>
</span>
<div class="zf-clearBoth"></div>
<p id="Address_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
</div>
<div class="zf-eclearBoth"></div>
</li><!---------Address Ends Here---------->
<!---------Radio Starts Here---------->
<li class="zf-radio zf-tempFrmWrapper zf-oneColumns"><label class="zf-labelName">Tinggal Dengan </label>
<div class="zf-tempContDiv">
<div class="zf-overflow">
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio2_1" name="Radio2" checktype="c1" value="Orang Tua">
<label for="Radio2_1" class="zf-radioChoice">Orang Tua</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio2_2" name="Radio2" checktype="c1" value="Wali">
<label for="Radio2_2" class="zf-radioChoice">Wali</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio2_3" name="Radio2" checktype="c1" value="Kost">
<label for="Radio2_3" class="zf-radioChoice">Kost</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio2_4" name="Radio2" checktype="c1" value="Asrama">
<label for="Radio2_4" class="zf-radioChoice">Asrama</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio2_5" name="Radio2" checktype="c1" value="Panti Asuhan">
<label for="Radio2_5" class="zf-radioChoice">Panti Asuhan</label> </span>
<span class="zf-multiAttType"> <input class="zf-radioBtnType" id="Radio2_others" type="radio" value="zfs-others-zfs" name="Radio2"><label for="Radio2_others" class="zf-radioChoice">Other</label>
<input name="Radio2_allow_others_text" type="text" maxlength="150"></span>
<div class="zf-clearBoth"></div>
</div>
<p id="Radio2_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Radio Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Jarak Tempat Tinggal ke Sekolah </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine5" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine5_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Radio Starts Here---------->
<li class="zf-radio zf-tempFrmWrapper zf-oneColumns"><label class="zf-labelName">Alat Transportasi ke Sekolah </label>
<div class="zf-tempContDiv">
<div class="zf-overflow">
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio3_1" name="Radio3" checktype="c1" value="Jalan Kaki">
<label for="Radio3_1" class="zf-radioChoice">Jalan Kaki</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio3_2" name="Radio3" checktype="c1" value="Kendaraan Pribadi">
<label for="Radio3_2" class="zf-radioChoice">Kendaraan Pribadi</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio3_3" name="Radio3" checktype="c1" value="Kendaraan Umum">
<label for="Radio3_3" class="zf-radioChoice">Kendaraan Umum</label> </span>
<span class="zf-multiAttType">
<input class="zf-radioBtnType" type="radio" id="Radio3_4" name="Radio3" checktype="c1" value="Ojek">
<label for="Radio3_4" class="zf-radioChoice">Ojek</label> </span>
<span class="zf-multiAttType"> <input class="zf-radioBtnType" id="Radio3_others" type="radio" value="zfs-others-zfs" name="Radio3"><label for="Radio3_others" class="zf-radioChoice">Other</label>
<input name="Radio3_allow_others_text" type="text" maxlength="150"></span>
<div class="zf-clearBoth"></div>
</div>
<p id="Radio3_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Radio Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">C.
KETERANGAN KESEHATAN</span> <br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!---------Dropdown Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Golongan Darah </label>
<div class="zf-tempContDiv">
<select class="zf-form-sBox" name="Radio4" checktype="c1">
<option selected="true" value="-Select-">-Select-</option>
<option value="A">A</option>
<option value="B">B</option>
<option value="AB">AB</option>
<option value="O">O</option>
</select>
<p id="Radio4_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Dropdown Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Penyakit yang Pernah Diderita </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine6" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine6_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Tinggi Badan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine7" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine7_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Berat Badan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine8" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine8_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">D.
KETERANGAN TENTANG AYAH KANDUNG</span> <br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nama Ayah Kandung <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine9" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine9_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Tempat & Tanggal Lahir <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine10" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine10_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pendidikan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine11" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine11_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pekerjaan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine12" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine12_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Penghasilan Per Bulan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine13" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine13_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Multiple Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Alamat Rumah </label>
<div class="zf-tempContDiv">
<span> <textarea name="MultiLine2" checktype="c1" maxlength="65535" placeholder=""></textarea> </span>
<p id="MultiLine2_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Multiple Line Ends Here---------->
<!---------Phone Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nomor Telepon/Handphone <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv zf-phonefld">
<div class="zf-phwrapper zf-phNumber">
<span> <input type="text" compname="PhoneNumber1" name="PhoneNumber1_countrycode" maxlength="20" checktype="c7" value="" phoneformat="1" iscountrycodeenabled="false" fieldtype="11" id="international_PhoneNumber1_countrycode"
valtype="number" phoneformattype="1" placeholder="">
<label>Number</label> </span>
<div class="zf-clearBoth"></div>
</div>
<p id="PhoneNumber1_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Phone Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Sosial Media </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine15" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine15_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Masih Hidup/Meninggal Dunia </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine16" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine16_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">E.
KETERANGAN TENTANG IBU KANDUNG</span> <br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nama Ibu Kandung <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine17" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine17_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Tempat & Tanggal Lahir <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine18" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine18_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pendidikan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine19" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine19_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pekerjaan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine20" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine20_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Penghasilan Per Bulan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine21" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine21_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Multiple Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Alamat Rumah </label>
<div class="zf-tempContDiv">
<span> <textarea name="MultiLine3" checktype="c1" maxlength="65535" placeholder=""></textarea> </span>
<p id="MultiLine3_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Multiple Line Ends Here---------->
<!---------Phone Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nomor Telepon/Handphone <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv zf-phonefld">
<div class="zf-phwrapper zf-phNumber">
<span> <input type="text" compname="PhoneNumber2" name="PhoneNumber2_countrycode" maxlength="20" checktype="c7" value="" phoneformat="1" iscountrycodeenabled="false" fieldtype="11" id="international_PhoneNumber2_countrycode"
valtype="number" phoneformattype="1" placeholder="">
<label>Number</label> </span>
<div class="zf-clearBoth"></div>
</div>
<p id="PhoneNumber2_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Phone Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Sosial Media </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine23" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine23_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Masih Hidup/Meninggal Dunia </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine24" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine24_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div><span
style="color: rgb(32, 33, 36); font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 16px; font-style: normal; font-weight: 500; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none">F.
KETERANGAN TENTANG WALI</span> <br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nama Wali </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine25" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine25_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Tempat & Tanggal Lahir </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine26" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine26_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pendidikan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine27" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine27_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Pekerjaan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine28" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine28_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Single Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Penghasilan Per Bulan </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="SingleLine29" checktype="c1" value="" maxlength="255" fieldtype="1" placeholder=""></span>
<p id="SingleLine29_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Single Line Ends Here---------->
<!---------Multiple Line Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Alamat Rumah </label>
<div class="zf-tempContDiv">
<span> <textarea name="MultiLine1" checktype="c1" maxlength="65535" placeholder=""></textarea> </span>
<p id="MultiLine1_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Multiple Line Ends Here---------->
<!---------Number Starts Here---------->
<li class="zf-tempFrmWrapper zf-small"><label class="zf-labelName"> Nomor Telepon/Handphone </label>
<div class="zf-tempContDiv">
<span> <input type="text" name="Number2" checktype="c2" value="" maxlength="18" placeholder=""></span>
<p id="Number2_error" class="zf-errorMessage" style="display:none;">Invalid value</p>
</div>
<div class="zf-clearBoth"></div>
</li><!---------Number Ends Here---------->
<!---------Description Starts Here---------->
<li class="zf-tempFrmWrapper zf-note"><label class="zf-descFld">
<div
style="font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: medium; font-weight: 500; letter-spacing: 0.1px; line-height: 24px; color: rgb(32, 33, 36); font-style: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px"
class="meSK8 G4EHhc">CATATAN<br></div>
<div
style="font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: medium; font-weight: 500; letter-spacing: 0.1px; line-height: 24px; color: rgb(32, 33, 36); font-style: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px"
class="meSK8 G4EHhc"><br></div>
<div
style="font-family: "Google Sans", Roboto, Helvetica, Arial, sans-serif; font-size: 12px; font-weight: 400; letter-spacing: 0.3px; color: rgb(32, 33, 36); line-height: 16.2px; margin-top: 0px; white-space: pre-wrap; font-style: normal; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px"
class="spb5Rd G4EHhc">
<div>1. Isilah Formulir secara lengkap dan benar sesuai dengan Akte Kelahiran (tidak boleh ada yang kosong).<br></div>
<div>2. Setelah mengisi formulir pendaftaran, silahkan membawa Foto Copy AKTE KELAHIRAN , KARTU KELUARGA (KK) & SURAT/PIAGAM KELULUSAN TK (Jika Ada)<br></div>
<div>3. Pas Photo Ukuran 2x3, 3x4, 4x6 ( masing-masing 10 lembar)<br></div>
<div>4. Mohon untuk mempersiapkan uang Rp.100.000,~ untuk biaya pendaftaran<br></div>
</div>
<div><br></div>
</label>
<div class="zf-clearBoth"></div>
</li><!---------Description Ends Here---------->
<!--Terms and conditions-->
<li class="zf-tempFrmWrapper"><label class="zf-labelName"> Saya mematuhi Syarat dan ketentuan <em class="zf-important">*</em>
</label>
<div class="zf-tempContDiv">
<div class="zf-termsContainer">
<div class="zf-termsMsg zf-descFld">
<div>Data yang kami masukan adalah benar dan sesuai <br></div>
</div>
<div class="zf-termsAccept"><input class="zf-checkBoxType zf-flLeft" name="TermsConditions" type="checkbox"><label class="zf-descFld">
<div>Setuju<br></div>
</label></div>
</div>
</div>
<p class="zf-errorMessage" elname="error" id="TermsConditions_error" style="display:none;">Invalid value</p>
<div class="clearBoth"></div>
</li>
</ul>
</div><!---------template Container Starts Here---------->
<ul>
<li class="zf-fmFooter"><button class="zf-submitColor">Submit</button></li>
</ul>
</div><!-- 'zf-templateWrapper' ends -->
</form>Text Content
* PPDB 2022/2023 SD MUHAMMADIYAH 03 KREATIF TANGERANG SELATAN Jl. Pamulang 2 Benda Barat 11 Komp. Ritan RT 03/09 Kelurahan Pondok Benda Kecamatan Pamulang Kota Tangerang Selatan * * A. KETERANGAN TENTANG DIRI SISWA/I * Nama Lengkap * Nama Depan Nama Belakang Invalid value * Nama Panggilan * Invalid value * Jenis Kelamin * Laki-Laki Perempuan Invalid value * Tempat & Tanggal Lahir * Invalid value * Agama * Invalid value * Status Yatim Piatu Yatim Piatu Invalid value * Nomor Telepon dan Handphone * Number Invalid value * Email * Invalid value * NIK Nomor Induk Keluarga * Invalid value * Anak ke- Invalid value * Asal Sekolah Invalid value * Alamat Sekolah Asal Invalid value * Upload Foto * Choose any file for this field. * B. KETERANGAN TEMPAT TINGGAL * Alamat Rumah (Sekarang) * Alamat 1 Alamat 2 Kota Kecamatan/Provinsi Kode Pos / Zip Code -Select- Åland Islands Afghanistan Akrotiri Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ashmore and Cartier Islands Australia Austria Azerbaijan Bahrain Bangladesh Barbados Bassas Da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Caribbean Netherlands Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Cook Islands Coral Sea Islands Costa Rica Cote D'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Dhekelia Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands (Islas Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Jan Mayen Japan Jersey Jordan Juan De Nova Island Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Reunion Romania Russia Rwanda Saint Barthélemy 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 Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Spratly Islands Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Bahamas The Gambia Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Island Wallis and Futuna West Bank Western Sahara Yemen Zambia Zimbabwe Kewarganegaraan Invalid value * Tinggal Dengan Orang Tua Wali Kost Asrama Panti Asuhan Other Invalid value * Jarak Tempat Tinggal ke Sekolah Invalid value * Alat Transportasi ke Sekolah Jalan Kaki Kendaraan Pribadi Kendaraan Umum Ojek Other Invalid value * C. KETERANGAN KESEHATAN * Golongan Darah -Select- A B AB O Invalid value * Penyakit yang Pernah Diderita Invalid value * Tinggi Badan Invalid value * Berat Badan Invalid value * D. KETERANGAN TENTANG AYAH KANDUNG * Nama Ayah Kandung * Invalid value * Tempat & Tanggal Lahir * Invalid value * Pendidikan Invalid value * Pekerjaan Invalid value * Penghasilan Per Bulan Invalid value * Alamat Rumah Invalid value * Nomor Telepon/Handphone * Number Invalid value * Sosial Media Invalid value * Masih Hidup/Meninggal Dunia Invalid value * E. KETERANGAN TENTANG IBU KANDUNG * Nama Ibu Kandung * Invalid value * Tempat & Tanggal Lahir * Invalid value * Pendidikan Invalid value * Pekerjaan Invalid value * Penghasilan Per Bulan Invalid value * Alamat Rumah Invalid value * Nomor Telepon/Handphone * Number Invalid value * Sosial Media Invalid value * Masih Hidup/Meninggal Dunia Invalid value * F. KETERANGAN TENTANG WALI * Nama Wali Invalid value * Tempat & Tanggal Lahir Invalid value * Pendidikan Invalid value * Pekerjaan Invalid value * Penghasilan Per Bulan Invalid value * Alamat Rumah Invalid value * Nomor Telepon/Handphone Invalid value * CATATAN 1. Isilah Formulir secara lengkap dan benar sesuai dengan Akte Kelahiran (tidak boleh ada yang kosong). 2. Setelah mengisi formulir pendaftaran, silahkan membawa Foto Copy AKTE KELAHIRAN , KARTU KELUARGA (KK) & SURAT/PIAGAM KELULUSAN TK (Jika Ada) 3. Pas Photo Ukuran 2x3, 3x4, 4x6 ( masing-masing 10 lembar) 4. Mohon untuk mempersiapkan uang Rp.100.000,~ untuk biaya pendaftaran * Saya mematuhi Syarat dan ketentuan * Data yang kami masukan adalah benar dan sesuai Setuju Invalid value * Submit