2. IDENTITAS GURU WALI KELAS

IDENTITAS GURU / WALI KELAS
Nama Lengkap

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

NIP

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

NUPTK

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

Tempat Tgl Lahir : ..................................................................................
Pendidikan Terakhir.................................................................................:
Jabatan Guru

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

Pangkat / Gol

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

Tugas Mengajar Kls..................................................................................:

Nama Sekolah

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

Alamat

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

Kelurahan

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

Kecamatan

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

Kab/Kota

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

Provinsi

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

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Guru Kelas
Foto
3x4
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NIP : ……………………….………..