DEPARTEMEN PENDIDIKAN NASIONAL KOTA SURABAYA
” TK PERMATA HATI “
NSS: 00.2.05.60.310.22
Jl. Dukuh Jelidro Baru Kavling 3-5 Rt.01 Rw.01 Kec. Sambikerep-Surabaya
Telp. 031-7408651
Nomor Pendaftaran : ...................................
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FORMULIR PENDAFTARAN
NAMA CALON MURID :.................................................................
TEMPAT / TANGGAL LAHIR :.................................................................
ALAMAT :.................................................................
NAMA ORANG TUA / WALI :.................................................................
ALAMAT ORANG TUA :.................................................................
:.................................................................
Surabaya,............................................
Orang Tua / Wali
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Kepala Sekolah
SOEKMAYANTI, Spd .
