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<title>form</title>
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<h1><p align="center">YAYASAN PENDIDIKAN MA'ARIF NU CABANG BOYOLALI</h1>
<p align="center"><U>FORMULIR PENDAFTARAN SISWA BARU</u></td>
</tr>
<tr><p align="center">Nomor Pendaftaran</p>
</tr>
<tr>
<td><ol type="A"><li>Identitas Siswa:</li>
</tr>
<tr>
<td><label for="textfield"><ol><li>Nama Lengkap(Sesuai Ijazah)<td align="center">
<td><label for="textfield"></label><input type="text" name="textfield"/></li>
<li>Jenis Kelamin</li><td><label for="textfield"></label>
<td><input type="checkbox" name="checbox" id="checkbox/>
<label for="checkbox">Pria
<input type="checkbox" name="checkbox2" id="checkbox2"/>Wanita</label></td>
<li>Tempat Tanggal Lahir</li></td><td><label for="textfield"></label>
<td><input type=text value="Boyolali"></td>
<td><label for="select"></label>
<select name="select" id="select"
<option>20</option>
<option>21</option>
<option>22</option>
<option>23</option>
<option>24</option>
<option>25</option>
<option>26</option>
<option>27</option>
<option>28</option>
<option>29</option>
<option>30</option>
</select>
<label for="select2"></label>
<select name="select2" id="select2">
<option>Januari</option>
<option>Februari</option>
<option>Maret</option>
<option>April</option>
<option>Mei</option>
<option>Juni</option>
<option>Juli</option>
<option>Agustus</option>
<option>September</option>
<option>Oktober</option>
<option>November</option>
<option>Desember</option>
</select></li>
<label for="select3"></label>
<select name="select3" id="select3">
<option>1995</option>
<option>1996</option>
<option>1997</option>
<option>1998</option>
<option>1999</option>
<option>2000</option>
<option>2001</option>
<option>2002</option>
<option>2003</option>
<option>2004</option>
</select></li>
<li>Agama:</li><select name="Agama"><td><label for="textfield"></label>
<option>Islam</option>
<option>Kristen</option>
<option>Hindu</option>
<option>Budha</option>
<option>Konghucu</option></select>
<li>Alamat Sekarang</li><input type="text" name="textfield"/>
<li>Sekolah Asal:</li>
<ol type="a"><li>Nama Sekolah</li><input type="text" name="textfield"/>
<li>Alamat Sekolah</li><input type="text" name="textfield"/></ol>
<li>Nomor Peserta Berdasarkan NISN</li><input type="text" name="textfield"/>
<li>Nomor Peserta Ujian SMP/MTs</li><input type="text" name="textfield"/>
<li>Nomor STTB/Tahun Lulus</li><input type="text" name="textfield"/>
<li>Nomor SKHUN</li><input type="text" name="textfield"/>
<li>Jumlah Nilai STTB rata-rata</li><input type="text" name="textfield"/></ol>
<li>Identitas Orang tua (Ayah):
<ol><li>Nama Ayah</li><input type="text" name="textfield"/>
<li>Tempat & Tanggal Lahir <input type="text" name="textfield"/><input type="text name=ttl value="">
<li>Agama</li><select name="Agama">
<label for="select5" id="select5">
<option>Islam</option>
<option>Kristen</option>
<option>Hindu</option>
<option>Budha</option>
<option>Konghucu</option>
<li>Pekerjaan</li><input type="text" name="textfield"/>
<li>Alamat Sekarang</li><input type="text" name="textfield"/></ol>
<li>Identitas Orang Tua(Ibu):
<ol><li>Nama Ibu</li><input type="text" name="textfield"/>
<li>Tempat & Tanggal Lahir</li><input type="text" name="textfield"/>
<li>Agama</li><select name="Agama">
<label for="select5" id="select5">
<option>Islam</option>
<option>Kristen</option>
<option>Hindu</option>
<option>Budha</option>
<option>Konghucu</option>
<li>Pekerjaan</li><input type="text" name="textfield"/>
<li>Alamat Sekarang</li><input type="text" name="textfield"/></ol>
</ol>
<p align="right">Boyolali...................................2017</p>
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