Nama lengkap
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Nama Panggilan Dani Ajeng Anggi Annisa Annisa Astri Dani ran ulis lham Ari 5agus Daid #ustoa Nabila Nailul Nanang Nurul 7ika ari ndah
TempatTglLahir Kudus,19Nopember1999 Kudus,2!April2!!! Kendal,11#aret2!!! 'epara, 11 (ktober 2!!! Kudus,2*&ebruari2!!! Kudus,)'uli2!!! Kudus,19Desember1999 ukoharjo,2+eptember19 Kudus,20April1990 Kudus,29#aret2!!1 Kudus, 19 Agustus 1999 Kudus, 2" 'uli 2!!! Kudus,20eptember1999 Kudus,1*#aret2!!! Kudus, !0 Nopember 2!!! Kudus,20Agustus1999 Kudus, Kudus,1+&ebruari2!!! Kudus, 21 #aret 1999 Kudus,!*'uni2!!1 Kudus,9#ei2!!!
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Nama lengkap
No 1 2 " $ ) + * 0 9 1! 11 12 1" 1$ 1) 1+ 1*
Ariana -hoirun Nisa 5ernikeNatali De6i Putri A.ungt.as Diu.andahPutri &erantanari &itria#eliana #eilinnaNurlesti.a Nadhita7araAndinira Nikita Nila ari Noita #itahul 'annah Nur &aida 7ahma6ati 7ahel=uliaKartika itiNur8anis.ah olikhatun CenaArzikKhumaidah >amronan
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Nama Panggilan Ariana 5ernike De6i Diu.a &era &itria Linna Nadhita Nikia Cita &aida =uli 8ani holi Cenna >am
TempatTglLahir
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Nama Panggilan
Angga&eriA.usanti Angga A.uAprili.antiAgustin A.u A.uekarari ekar 5ella#aulinaari 5ella /ndahekar#anah /ndah &iska#eliana &iska &itriana ari &itri 8en.et.a6ati 8en. ndahLestari Lestari ndahNoorLail. ndah 'amilatul 8ida.ah #ila KarlinaTr.Anggraeni Lina Labibatul la..a #aimanatur 7usdah la..a LiandriAstuti Lia #oni3aAprilianti #oni3a Noraidah dah Nur8asanah Ana Nurul#uFalina Lina 7ezaAndre.aniPutri 7eza 7ikaetiani 7ika 7irin(ktaia 7irin 7iziDe6iAnggraini 7izi ha%ra#ariana &ira ugiani=uniAzhari =uni Cera/ka#eilani Cera Ciana Cia 4inda/rlinaPutri 4inda =uniPuspitaari =uni
usia 1$ usia 1) usia 1+ usia 1* A 10 jumlah
TempatTglLahir
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Pekerjaan
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Alat Transportasi 'alanKaki Antar 'emput #otor Angkutan #otor #otor #otor #otor epeda epeda epeda epeda epeda < #otor 'alanKaki 'alanKaki #otor #otor #otor epeda #otor #otor 'alanKaki #otor #otor epeda
Prestasi =g Pernah Diraih
No Darurat
!0)*2++1!))* !09)!")9+**) !0)"2)!0*0*$ !09++9222)90 !01"9!)211*" !0)"2+2$10)) !0)0*)0")919 !0)291")191* L(#5A 5A-A DAN 5A !0)+$!9*$!$" < < < !0122)))19+0 < !021"")"0)10 'A7A 1 P7 'AT/N;, ' !0*0"1+"+020 < !0)29!))1$+" < !01"2++)"1*) < !0)*$0*2)0!0 < !0)0++$"1"2$ < !01"2)!!9)"+ < !0)+2*"!)1$ < !0)+$1"2!*)) &/TCAL#K T7AD !0)*2*)$1$$$ < !021)"92)++0 < < < !0)0+)))0)1 < < < !0)29!"0!02+ 5(LAC(L= !01"2)$)+$)+ < !0)22)29$90+
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Nama lengkap
No 1 2 " $ ) + * 0 9 1! 11 12 1" 1$ 1) 1+ 1* 10 19 2! 21 22 2" 2$ 2) 2+ 2* 20 29 "! "1 "2 "" "$ ") "+ "* "0 "9
Adilla=uliani Agustina Andri.ani Aina.a 7izi AldaNilam7iziani Anggita-orn.3oa Ari D6i a%tri A.u Lestari -ah.aPramudita -husnul 8ida.ah Da%a&ardail%aNoor DeiPujiAri.ani Diah A.u a%tri Diahzdhar4BA Dian &itriani DitaD6iDama.anti /langPrakoso &ajarTulistian &enina April &itriaA.ukNingsih ndraur.anigrum Lia 8anda.ani LindaD6i7madhani Linda 8usna #aulida#eilina #aulidaNingrum #a.a Kadilla #a.laA.uisianti Noor Aina Noor Khalimah Noitaetiara Nurul Arinda Nurul8ida.ah 7ahmadupri.ani 7ahmatupri.anto 7estiArum'ulinti 7isa&ebrianti iska Adiba iti#a.a>ulena ukron7omdoni usia 1$ usia 1)
Nama Panggilan Adilla Tina Na.a Alda Anggita &itri A.u -ah.a Di.ah Da%a Puji A.uk Diah Dian Dita /lang &ajar &enina A.uk ndra Lia Linda Linda Lina Arum #a.a #a.la Aina ma Noi Nurul Nurul Adi Antok Arum 7isa iska #a.a Doni
usia 1+ usia 1* A 10 jumlah
!
Tempat Tgl Lahir Kudus,20'uli1999 Kudus,20Agustus2!!! 'epara, " eptember 1999 Kudus,1"'uni2!!! Kudus,19'anuari2!!! Kudus,1!'anuari2!!1 ;robogan,1$'uli2!!! Kudus,2"'anuari2!!1 Kudus,1+Noember2!!! Kudus,12&ebruari2!!1 Kudus,29'anuari2!!! Kudus,1!(ktober2!!1 Kudus,!2Desemer2!!! Kudus,2"'uli2!!! Kudus,1$eptember2!!! Kudus,1)'uni1999 Tasikmala.a, 21 Desemer 1999 Kudus,1)April2!!! Kudus,2"'uli1999 Kudus,19Agustus2!!! Kudus,9'uli2!!! Kudus,1*Desember2!!! Kudus,1+'anuari2!!! Kudus,2"#ei2!!! Kudus,21'uni1999 Kudus,2*Agustus1999 Kudus,!1'uni2!!! Kudus,19#aret2!!! Kudus,12&ebruari2!!! Demak,!1#aret2!!! Kudus,"eptember2!!! Kudus,10'uni2!!! Kudus,10'uni2!!! Kudus,2"'uli2!!! Kudus,2+&ebruari2!!! Kudus,1$(ktober1999 7imbo5ujang,2+'uni1999 Kudus,2$Desember1999 LAK LAK P/7/#PAN
L:P P P
Agama
LA# LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# L LA# L LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# P LA# L LA# L LA# P LA# P LA# P LA# P LA# L LA# ) "$
T(TAL
"9
Asalekolah #P 58AKT P7A'A KAL4N; #P2;/5(; #P 1 NAL#A7 '/PA7A #T N #AT8(L?L 8DA #P25A/ #TNAL<8DA=A8 #P)KD #PTA#AN D/4AA #T N #AT8(L?L 8DA #T N #AT8(L?L 8DA #PN#A?A7& #PTA#AND/4AA #TN 1 KD #TNAL<8DA=A8 #PTA#AND/4AA #P$KD #P " KA8/NN; #P #8A##AD=A8 1 KD #P 58AKT P7A'A KAL4N; #P TA#AN D/4AA #P25A/ #PNAL#A?7& #PTA#AND/4AA #PTA#AN D/4AA #P 58AKT P7A'A KAL4N; #P15A/ #P 58AKT P7A'A KAL4N; #PTA#AND/4AA #T TANA4=A8 AL<&7HAN #TN P/-AN;AAN 5A4 '/PA7A #P$KD #PTA#AND/4AA #PTA#AND/4AA #PTA#AND/4AA #P2KAL4N; #P TA#AN D/4AA #PTA#AND/4AA #TLA#--/NT7/ #PTA#AND/4AA
AlamatTempatTinggal 5akalan Krap.akrt + 76 2 Kedungari7t"761;ebogKudus Ngetuk 7t" 76 2 Nalumsari 'epara Kebon Agung 7t $ 76 " Krandon Kudus Panjang7t1761 NgaringanKlumpi 5urikan5aru7t$761 #odinan Klumpit 7t1 76 * ;ribig 7t 1 76 1 ;ebog Kudus Pring e6u 5akaln Krap.ak 4ergu4etan7t$761 ingo3andi7t1762 ambengkarangmalang 7t2 76$ ;ebog Kudus ;etasrabiKendeng Dema?An7t$76$ DesaTegalArum7t)76" Desa ;etas Pejaten 7t 1 76 2 'ati 5urikan 5aru 5akalan Krap.ak 7t $ 76 1 ;rogol Loji 5akalan Krap.ak Kramat5esar$+957t)76$ ;etasPejaten Peganjaran7t$761 'ekulo Kauman 7t " 76 11 ;ribig 7t 1 76 $ ;ebog Kudus DesaPanjang7t$762 Nganti Karangngampel Kradenan7t276+ Desa ;arung Lor 7t ) 76 1 Dema?An Kota Kudus DukohKrandon7t2761 Dema?An ;lantengan7t276" ;lantengan7t276" PrambatanLor7t2761 Desa Peganjaran 7t 2 76 1 Panjang7t1761 Karang5ener ingo3andi7t+76"
No8p:Telp
!0)*2*"*+200 !0*0"100")0) !09)1")!1$!1 !09090+$221* !09)2+"*92*! !0)0+)!9!0!9 !09+"1)1"2+! !09+++)!$*)* !09)!"0)"19! !0)0*)"99+)+ !09)10!*9*") !0)**!*00 !09++$*""!2* !0"02+2"1))0 !0)0*)"9*920 !0)22*!)!!1" !0)+!!$010!! !09)!9"22"$! !09++)+10191 !0)**0"02*$! !0)*1"2!!1+" !01"91"9**2*2 !0)0*)9"+)$! !09++01022*! !0)*$!+""1$0 !09+022+1)00 !09*!92!)!+ !09+1120$2+1 !09)1**0!9$! !09+0*9$"+92 !09)20!9+00! !09*!*")*21 !0)+$1)0+!0" !021")!!29"*
NamaA.ah uti.anautei 7udi8artono upri.ono Abdul7o3hman on. D6i 7istianto ugianto Pribadi >uli.anto #o3hlas Nor7ahmat #uhammad8aris #as.ono Noor8adi utrisno #asdi @Alm 'oni ukamto 'ajang /mpon ur.ana #o3h.a?7oni Ngadiran uharto Totok udarto @Alm upadi uprapto Nur hodi @Alm Ngatum uraji@Alm Asis 4idodo ulhadiPra.itno udarno elamet5usro A3hmad'unaedi 'upri.anto@Alm 'upri.anto @Alm Kasdi Pujitomo ubadi #B umanggih 7aharjo unarAri%n
Pekerjaan
Pendidikan
5uruh #P 4iras6asta #A 4iras6asta D opir D Kar.a6an 6asta #A opir #T 5uruh D Kar.a6anDjarum #/A 5uruh #A 4iras6asta #A 5uruh #A opir D Kuli5anginan D 5uruh #P D N.upir #P 4iras6asta D 5uruh6asta #A 4iras6asta:Temb D 5uruh D 5uruh 4irausaha 5uruh eri3eLampu 4iras6asta 4iras6asta 6asta opir 4iras6asta
5uruh PerangkatDesa Kar.a6an 4iras6asta opir
D #K T# TA#ATD D #P D D D #P #P D D #A D T# D
Penghasilan
Namabu
7p 2,!!!,!!!B!! uparni 7p 1,!!!,!!!B!! antietiani 7p 0!!,!!!B!! Pasi.am +!!!!!:TDAK PAT .aa?Atun 7p 9!!,!!!B!! De6iNur8anda.ani 7p +!!,!!!B!! u3iati TDAKPAT Amirah 7p 1,)!!,!!!B!! =uningAstuti 7p 1,)!!,!!!B!! iti&aizah 7p 1!!,!!!B!! Noor Azizah 7p +!!,!!!B!! =uni ulistri.orini 7p 1,)!!,!!!B!! #unasri 7p 1,!!!,!!!B!! 8anda.ani Purbetti 7p 9!!,!!!B!! untani Tukimah 7p *!!,!!!B!! Trimul.ani 7p 1,)!!,!!!B!! 8eni#eliana 4arni 1 !!!!!!:TDAKPAT5asmi 12!!!!!:TDAKPAT 4agirah o%ah 7p *)!,!!!B!! ukarni 7p )!,!!!B!! unami #ul.aningsih 7p 0!!,!!!B!! ri=ati 7umi.ati TDAKT/NT TriAnggraheni 7p 1,"!!,!!!B!! 7o3ha.ati 7p 0!!,!!!B!! #alikatin 7p 2,!!!,!!!B!! iti#una6ati 7p 1,)!!,!!!B!! &aridaAri.ani 7p 1,!!!,!!!B!! ustriani #ur.ati #ur.ati 7p 1,!!!,!!!B!! uharisih 7p 1,!!!,!!!B!! ri7ezeki 7p 1,)21,"2!B!! 4arsikah 7p 1,)!!,!!!B!! iti .amsi.ah 7p 1 ,!!!,!!!B!! uripah
Pekerjaan bu7t bu7t 4iras6asta Pedagang 5uruh 5uruh bu7t 5uruh 4iras6asta bu 7t 5uruh bu 7t 5uruh bu 7t bu7t bu7t bu 7t bu7t 5uruh
Pendidikan
D #A D #A #A # #P #P #A #A #A D #K #P #P D D #A D #A
bu7t D 5uruh D 6asta # 5uruh #P Pedagang TA#ATD 5uruh #P bu7t #P 5uruh D bu7t D bu7t D 4iras6asta #P 5uruh 7t D 5uruh 7t D bu7t #A 5uruh #P Kara6an D 4iras6asta TAN4=A8 5uruh D
Penghasilan
Alamat(rangtua
NoTelp:8p
A#A A#A !01"2)"2"++* 7p "!!,!!!B!! A#A !0*00*"*"+") +!!!!!:TDAKPAT A#A !0)29!")+0$) A#A !0)"2)2)+!*$ 7p 2!,!!!B!! A#A !0)22))$2*"1 9!!!!!:TDKPAT A#A !0)"2)$$))20 A#A !0**$+2"+$$+ 7p 1,$!!,!!!B!! A#A !0222)1"$)*0 7p 1!!,!!!B!! A#A !0)29!9$!!$* A#A !0)2!!9012"* 7p +)!,!!!B!! A#A !0)22+2*9$29 A#A !0)*29912$02 7p *!!,!!!B!! A#A A#A !0*0"1"*0"12 A#A D/A NDAK/7/TA KA5 TAK#ALA=A A#A !0)+$!!2)29* A#A 12!!!!!:TDAKPAT A#A !0)22+)$)$"1 A#A A#A !0)+$!+)+++* 7p "!,!!!B!! A#A 7p )!!,!!!B!! A#A !0)22)2122)! A#A !0)+!!20999+ 7p )!!,!!!B!! A#A !01"91"9**2* 2!!!!!:#N;; A#A !0)29"$$+9$) A#A !0)"2)$0$**9 7p )!!,!!!B!! A#A !0)+$1)!$!19 N;/;(T 7T " 74 1 #'/N D/#AK !0)+$12"*1+2 A#A !02"22)90**2 7p )!!,!!!B!! A#A 7p )!!,!!!B!! A#A 7p +!!,!!!B!! A#A A#A !09+0*9$"+92 7p 1,2)!,!!!B!! A#A !0)22+29!$0$ 7p 1!!,!!!B!! A#A !09+"!11!1)+ 7p 1,)!!,!!!B!! 'A#5 7p 1,!!!,!!!B!! A#A
'umlah audara " 1 2 1 2 $ 2 2 1 1 1 2 1 2 2 1 2 ) 1 " 1 2 2 1 $ " 1 1 1 2 1 ) $ 1 2 2 " $
7i6a.at Kesehatan #AA;DANA#AND/L
Alat Transportasi
Prestasi =gPernahDiraih
#ontor #ontor #ontor AKT T& epeda Antar 'emput #A;8 Kendaraan T=P/ #ontor epeda epeda epeda epeda PA7
No Darurat
!01"2)"2"++* !0*00*"*"+") !0)29!")+0$) !0)"2)2)+!*$ !0)22))$2*"1 !0)"2)$$))20 !0**$+2"+$$+ !0)29!9$!!$* !0)2!!9012"* !0)22+2*9$29 !0)*29912$02 !0)11""$$)+9 !0*0"1"*0"12 !0"02+2"1))0 !0)+$!!2)29* !0)22+)$)$"1 !0)***$)+*92 !0)+$!+)+++* !0)22)2122)!:?!0)29!)")+!! !0)+!!20999+ !01"91"9**2* !0)29"$$+9$) !0)"2)$0$**9 !0)+$1)!$!19 !291$$29"* !0)22)2$*1))
!0**""9)01)* !0)22+29!$0$ !09+"!11!1)+ !0)+$1)0+!0"
5/AA4A
Nama lengkap
No 1 2 " $ ) + * 0 9 1! 11 12 1" 1$ 1) 1+ 1* 10 19 2! 21 22 2" 2$ 2) 2+ 2* 20 29 "! "1 "2 "" "$
A5DL ;8(&7 A#ANDA #A7DL==AT A?ADA8 ANA P' L/TA7 AN;; #A7D=AN A7LNDA(KTACAN A= 4LAN A7 D/C A;TN D/4 #74AT D/4#TA7APPTAA7 D8A5TALA5LA;8AAN &A7DAT ANA 8/7LNDAA5/LLAA&T7 NDA8 7ATNA A7 'LNA T(T &(7/LLA L/N 7(TA L/=NA&/7NTANN;7# LT&ALA==NATALA5/LLA #/LNDA&/7LAN/T=(4AT #/LL/NAD4'LTA #/= N/L= ATT NA5LLA&KAK(7N/LA N((7 LAL= N(C/LLANA/NDN/PT7 N(CATAD4NN;7# N7L #A/A7(8 7NA A7DNATA AL4ALD4C7AAND7N 8/7L=-A8=ANT 8/7L=PT7AN;;7/N T=A T>>A7(A # LAT&A8 CK A#/L=A8 =D8A P7A#TA =7DA A#ALA usia 1$ usia 1) usia 1+ usia 1* A 10 jumlah
Nama Panggilan ;8(&7 A#ANDA ANA AN;; A7LNDA A= D/C D/4 TA7A D/55= ANA 5/LLA NDA8 'LNA L/N A7# 5/LLA LNDA NA N/L= 5LLA LAL= NA CTA N7L 7NA AL4A 8/7L= 8/7L= T=A # A#/L =D8A DA
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Tempat Tgl Lahir KD, 11 'N 1999 KD, 2+ /PT/#5/7 199 KD, 22 'ANA7 2!!1 KD, !* #A7/T 2!!1 KD, "1 (KT(5/7 2!!! KD,2*'N2!!! KD, 1+ A;T 2!!! KD, !) D//#5/7 2!!! KD, 1+ (KT(5/7 2!!! KD,!2 'L2!!! KD,11'L2!!! KD, !" N(C/#5/7 2!!! KD, 10 /PT/#5/7 2!! KD,2!'L2!!1 KD, 1! A;T 2!!! '/PA7A, 1* 'N 2!!! D/#AK,2 'N 2!!1 KD,+#/1999 KD,1"'L2!!! KD, 2$ #/ 2!!! KD,!1#/2!!! KD, $ A;T 2!!! KD, 1* N(C/#5/7 2!!! KD,19'L2!!! KD,!$#/2!!! KD, !+ A;T 2!!! KD, 20 #A7/T 2!!1 KD, 1 /PT/#5/7 2!!! KD, 1" (KT(5/7 2!!! KD,12'N2!!! D/#AK,"1'L2!!! D/#AK, 10 #A7/T 2!!! KD,20'L2!!! KD, 20 /PT/#5/7 2!!
LAK < LAK P/7/#PAN T(TAL
L:P L P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P
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Asal ekolah #P TA#AN D/4AA #P $ KD #P 1 DA4/ #P 2 5A/ #P $ KD #P2'AT #P $ KD #P N AL #A?7& #P TA#AN D/4AA #P1 #A=(N; #P2;/5(; #P 2 ;/5(; #P 1 DA4/ #P$KD #P 1 5A/ #T NA8DLATL LA#A 'N #T N '(;(L(=( #P)KD #P"KD #P N AL #A?7& #P1;/5(; #T N 7ADLAT 85=A #P 2 5A/ #P1DA4/ #P$KD #P 1 DA4/ #P 58AKT P7A'A KAL4N #P 1 'AT #P #8A##AD==A8 1 K #P2;/5(; #P$KD #P 2 5(NAN; #P2;/5(; #P 2 ;/5(;
AlamatTempatTinggal
No8p:Telp
NamaA.ah
'AT KL(N (L/8 'AT KL(N 7T 1 74 ) !09+$"0""099 KA7T(N( K4KAN 7T $ 74 1 -(L( !0)+$1!*22)9 AL #A8A7 D/7ALA#7T2741 !090*12!!") TA#A7 D;75;7T"741 !09+9*9)9!+! '(K(#T(N( ;/TAP/'AT/N7T274" !0)0*)+02*"! #A8AD 'AT KL(N 7T ) 74 1 !09++)9!!*90 7 8A7#ANT( 4/7;KL(N7T"742 !09)!*02!9+* AD PL((7T"741 !0)*2*2$2$$) 4A7'(N(/DAPT7( P/LAN; 7T 2 74 2 #A=(N; '/PA7A !09++*9000"0 A#=(N( K/DN;A77T2741 !0)291*92**+ P7=ANT( 5/T( KA#AN !0191!99$)+! 8/7 4ANT( 5A-N 74 7T 02 #A7D PL(( 74 7T $ 2 =(T( P/;AN'A7AN7T"741 !099!*$+!!$ 5A7 'N;;(TAN 5AN;7 '/PA7A !0)29!)+)"09 P7=ANT( D D/#AAN K(TA KD !0*0"10$9"92 8/N;K PA7LAN 7/ND/N;7T$74+ !0)"2)!0+!2! #A#N P74(A77T"74$ !0)+))129*2+ N;AT(N( ;/TAP/'AT/N7T1741 !09+12$9)+") =ANT( '7AN; ;/T 7T " 74 2 #TA4 N;(-AND7T " 74 2 !09+)"!!229$ A7& N((77(&A? D/7ALA#7T2741 !09022!209) /DP74ANT( 5A/ K7A'AN !0)*$2*+2029 &A>N PA78ANL(77T"74" !090*!1200* K#N PAN'AN;7T2741 !0)*"2!"9+01 'AD=(N( DK KA7AN; PAK D '/PAN; PAK 7T !0)22+2)*$*+ AND ANANTA 8AD PA78ANL(77T$740 /D=4AL=( DA#A7AN;P/TA'/N !01"9!$"211! A;4ANT( 5/T( 7T $ 74 " KA#AN !09)190+"!)$ 8A7=ANT( D/A PL(( 7T 74 2" A7&N D D/#AAN K(TA KD !0)0+)!$)21$ A#L AN4A7 K/DN;A77T274) !0)*$!*0")21 8DB8@AL# 5/T( 74 7T $2 #(8 AL
Pekerjaan
Pendidikan
P/N;AN;;7AN D 47A4ATA #P 578TAN D 578 D 578 D 47A4ATA #P 578 #A 47A4ATA D 47A4ATA D P/7AN;KATD/A LTA 578 D 578 #A 578 D KA7=A4AN D'A7# D 578 D 4ATA D 4ATA D 47A4ATA #A P7 #P 4ATA T# 47A4ATA #A 578 #A 578 LTP 578 #P D P7 #K 47A4ATA #A 8(N(7/7 P/N'A;A #A 4ATA D" 578 D 47A4ATA LTA P/TAN D 1 578 #P
Penghasilan
Namabu
7KA7TN@AL# TDAK T/NT 7 #A7=AT $!!!!:8A7 '#?A8 7p 2!!,!!!B!! TN 7p 1,!!!,!!!B!! #NTANA8 7p *)!,!!!B!! P7=ATN 7p )!!,!!!B!! 'A#NA8 7p 1,)!!,!!!B!! ANAPT7 7p *!!,!!!B!! 7#7N 44K=ANT 7p 1,0!!,!!!B!! N7-8AANA8 1!!!!!!<2!!!!!! 7#/LAT 7p 1,)!!,!!!B!! 75?A8 7p 1,)!!,!!!B!! #=AT TDAKT/NT TA7N TDAKT/NT (&NATN#ALKA8 7p 9!!,!!!B!! AN=ATL#T8A7(8 7p 1,2!!,!!!B!! 7ATNA 4AT 7p 2,!!!,!!!B!! /7NN;/T=ANN;8 7p 0!!,!!!B!! A7T 7p 2,)!!,!!!B!! L&A >==NA 7p )!!,!!!B!! 7TKNN;8 N/ K#A4AT TDAKT/NT D48A7TATK A&?A8 TDAKT/NT 4ATN 2!!!!!!:"!!!!!! /NDA8 LT=A7N 7p 22),!!!B!! T K8(LA8 7p 2,!!!,!!!B!! NDA8&AAT 7p 1,!!!,!!! TP'A8 7p 1,)!!,!!!B!! T KA7(#A8 7p *!!,!!!B!! #ATN N((7 >AA 7p 2,!!!,!!!B!! T#L=AT
Pekerjaan
Pendidikan
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Penghasilan
7p 7p 7p 7p 7p 7p
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Alamat(rangtua
NoTelp:8p
'umlah audara
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Alat Transportasi /P/DA #(T(7 AN;KTAN #(T(7 ANTA7 '/#PT #(T(7 /P/DA /P/DA #(T(7 #(T(7 #(T(7
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Nama lengkap
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Nama Panggilan DLA CNA A&A A&A 5/LLA 5/TA D/C DAN DNA #ALA D=A8 &AN /L;A && NA &&A8 NAD=A NLA A7# N((7 N(CTA A&&A8 N7L D=A8 PT7 7#A 7TAN 7>A 7>K 7 DA /7L= /TA NA5LA LC AN CKA 8ANA =NTA >#
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Asalekolah
AlamatTempatTinggal
#P TA#AN D/4AA 57KAN 7T 1 74 1 #P$KD PA78ANL(77T174) #T N 5TDAL &ALA8 K7AND K/DN;A7 7T $ 74 + #P2;/5(; KA7AN;#ALAN;T7"742 #P N AL #A?7& '/TAK K/#5AN; 7T !2 74 + #P15A/ P/7#A8AN;/75AN;8A7APAN #P"5A/ ;75;#N/N;7)74" #P TA#AN D/4AA KALPT 7T $ 74 2 #P TA#AN D/4AA D L(7A# 4/TAN 7T !" 74 !$ #P1DA4/ KA'A77T!274!1DA4/ #P #8A##AD=A8 1 K 5AKALAN K7AP=AK 7T 1 74 1 #P1DA4/ D(7/'(P=(8DA4/ #P2'AT PA78ANKDL7T$74" #T N K8(7=A8 5A/ K 5A/ KA7AN; D(4( #PN ) KD D 5ALAT/N;A8AN N(B 22*0 KD #PTA#AN D/4AA 57KAN #P1'AT PA78ANL(77T174* #P 2 KAL4NN; T/7(N( ;A7N; L(7 #P"KD 5AKALANK7AP=AK7T1741 #P$KD D/#AN;AN #P2'AT PA78ANL(77T"741 #P25(NAN; D/#A?ANK(TAKD #P15A/ 5A/K7A'(N7T2741 #P N AL #A?7& '/TAK K/#5AN; 7T !" 74 ) #P TA#AN D/4AA 'L -/#PAKA N( 2! 5 @D N;AN;K #P1NDAAN #/DNNDAANKD #TN2KD #LATKDL7T+741 #T TA=4HL 5ANAT '/P 5DA KA5L PN;;7 5ATA# #P N AL #A?7& 4/7; 4/TAN KD #P2 DA4/ PA-KA7AN LA4 DA4/ KD 7T !+ 7 #T N7L 8DA KD K/DN;D(4( T/#P/L #P N AL #A?7& ;/TA P/'AT/N 7T $ 74 2 #P15A/ -/ND(N(KL/5AK7T174* #P$KD 5A-N7T+741 #P1'AT PA7A8ANL(77T274$ #T N 5TDAL &ALA8 K/DN;A7 #5AT7 7T + 74 0 #P TA#AN D/4AA D ;LANT/N;AN 7T " 742 #P2DA4/ KANDAN;#A7T2741+ #P$KD N;(-AND7T2741 #P$KD K7AND(N7T!+74!1
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NamaA.ah
Pekerjaan
Pendidikan
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Penghasilan
Namabu
Pekerjaan
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Penghasilan
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'umlah audara
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Prestasi =g Pernah Diraih
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