Professional Documents
Culture Documents
Wonosobo, ...............................................
Yang menyatakan
Hormat kami,
........................................................
A. IDENTITAS SANTRI
1. Nomor Induk : ........................................................................(diisi petugas)
2. Nama Santri : .........................................................................................................
3. Nama Panggilan : .........................................................................................................
4. Temp./Tgl. Lahir : .........................................................................................................
5. Jenis Kelamin : .........................................................................................................
6. Anak Ke : .........................................................................................................
7. Sekolah/Kelas : .........................................................................................................
B. ORANG TUA/WALI
1. Nama Lengkap :
.........................................................................................................
2. Pekerjaan : .........................................................................................................
3. Alamat : .........................................................................................................
Untuk kelancaran proses pendidikan di TPQ. Al Khusna ini, maka kami ikhlas memberikan
infaq setiap bulan sebesar Rp. 15.000,-/Rp. 17.500,-/Rp. 20.000,-.
Wonosobo, ...............................................
Hormat kami,
{......................................................}
Orang tua/Wali
Keterangan: