BORANG PROFIL MURIDPEMBIMBING RAKAN SEBAYA (PRS)

KELAS

NAMA GURU KELAS

TAHUN

1. PERIBADI

1.1 Nama : _______________________________________

1.2 Umur : ______________ 1.3 Jantina : ____________

1.4 No. Kad Pengenalan : _______________________________________

1.5 Tarikh Lahir : _______________________________________

1.6 Alamat Rumah : _______________________________________

_______________________________________

1.7 No Telefon Rumah : _______________________________________

2. BUTIRAN BAPA

2.1 Nama : _______________________________________

2.2 Umur : _______________________________________

2.3 Pendapatan Sebulan : RM ___________________________________

2.4 Alamat Pejabat : _______________________________________

_______________________________________

2.5 No. Telefon Pejabat : _______________________________________

2.6 No. Telefon Bimbit : _______________________________________

3. BUTIRAN IBU

3.1 Nama : _______________________________________

3.2 Umur : _______________________________________

3.3 Pendapatan Sebulan : RM ___________________________________

3.4 Alamat Pejabat : _______________________________________

_______________________________________

3.5 No. Telefon Pejabat : _______________________________________

3.6 No. Telefon Bimbit : _______________________________________

GAMBAR TERKINI