Penyaluran Tunjangan Profesi Guru (TPG) Bulan Juli-Desember 2017 (Guru RA Madrasah) Revisi SEKSI PEDIDIKAN MADRASAH Biodata_guru

BIODATA GURU
PENERIMA TUNJANGAN PROFESI GURU
1. Nama lengkap dan gelar

: ...........................................................................

2. NIP.

: ...........................................................................

3. Tempat/Tgl.Lahir

: ...........................................................................

4. Pangkat/Gol.

: ...........................................................................

5. Mapel/Guru Kelas

: ...........................................................................

6. NSM / NSS

: ...........................................................................

7. Nama RA/Madrasah

: ...........................................................................

8. Alamat RA/Madrasah

: ...........................................................................

9. Kecamatan

: ...........................................................................

10. No.Telp. RA/Madrasah

: ...........................................................................

11. Jumlah Rombel

: ...........................................................................

12. Jumlah Siswa

: ...........................................................................

13. NUPTK

: ...........................................................................

14. NRG

: ...........................................................................

15. Nomor SK Dirjen

: ...........................................................................

16. Tgl. SK Dirjen Pendis

: ...........................................................................

17. Tahun Lulus Sertifikasi

: ...........................................................................

18. LPTK

: ...........................................................................

19. Tugas Utama Mengajar

: ................................... JTM

20. Tugas Tambahan

: ................................... JTM

21. Jumlah JTM (No.19+20)

: ................................... JTM

22. Alamat Rumah

: ...........................................................................

23. Kode POS

: .................................... (wajib diisi)

24. No.HP./Telp. (pribadi)

: ...........................................................................

25. Nama Gadis Ibu Kandung

: ...........................................................................

Surabaya,

September 2017

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*) Data mohon diisi dengan lengkap dan benar;