Format Instrumen Rekomendasi Permintaan

Rekomendasi Peminatan

Nama                                                 :  ...................................................

Jenis kelamin           :  .................................................

NIS                                       :   .........................................................

Sekolah                   :   ............................................................

Alamat                     :   .............................................................

Aspek	Sub Aspek	Hasil	Keterangan
Nilai raport	Matematika
	IPA
	IPS
	B.Indonesia
	B.Inggris
Tes	IQ
	Bakat
	Minat
Prestasi	Akademik
	Non Akademik
Pilihan	Siswa
	Orang tua

Rekomendasi

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                                                                            YOGYAKARTA, .......................................

                                                                            Guru BK/Konselor,

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