PEMERINTAH KABUPATEN GARUT

DINAS PENDIDIKAN

SMP NEGERI 1 SINGAJAYA

Alamat : Jalan Raya Singajaya

Garut 44173
LAPORAN KUNJUNGAN RUMAH (HOME VISIT)
Nomor : 422/...............-SMP/2009
I. IDENTITAS :
a. Nama Siswa
: ________________________
b. K e l a s
: ________________________
c. Nama Orang tua/Wali
: ________________________
d. Pekerjaan Orang tua/Wali
: ________________________
e. Alamat
: ________________________
________________________
II. TUJUAN HOME VISIT :
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
III. HASIL KUNJUNGAN :
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
IV. KESIMPULAN :
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Singajaya,
_____________ 200
Mengetahui
Pembimbing
Kepala SMPN 1 Singajaya

Ahmad Gunawan, BA, S.IP., M.H.

KURIKULUM SMP NEGERI 1 SINGAJAYA

Guru

___________________

NIP. 131013926

KURIKULUM SMP NEGERI 1 SINGAJAYA

NIP.