LEMBAGA PEPERIKSAAN MALAYSIAKEMENTERIAN PELAJARAN MALAYSIA

BORANG PENGESAHAN

MENJALANKAN TUGAS PENYELARASAN PEKA

NAMA PETUGAS:

NAMA PENTAKSIR DILAWATI:

(KPK/KPN/KPKw/PKw/KPS)*

(KPN/KPKw/PKw/KPS/PS)*

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ALAMAT SEKOLAH PETUGAS:

ALAMAT SEKOLAH DILAWATI:

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Tarikh Lawatan/Penyelarasan: .............................

BILNama Calon diselaraskanTahun / Angka Giliran

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Tandatangan Petugas.

Tandatangan Pentaksir:

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Tarikh:..............................................

Tarikh:...................................................

Tandatangan Guru Besar Petugas

Tandatangan Guru Besar Sekolah Dilawati

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