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| | | | | LAPORAN INDIVIDU SEKOLAH DASAR DAN MADRASAH IBTIDAIYAH | | | LI-SD/MI | |
| | | | | | | | | | | | | TAHUN PELAJARAN | | : | 2011/2012 | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | KEADAAN 31 JULI | | | : | 2011 | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | KODE KECAMATAN | | : | | *) Diisi oleh Petugas Kab./Kota | | | | | | | | | | | | | |
| | | | | | | | | | | | | (SEBELUM MENGISI, BACALAH PETUNJUK PENGISIAN) | | | | | | Nomor Statistik Sekolah | | | |
A. | IDENTITAS SD/MI | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 111235180082 | |
| 1. | Nama Sekolah/Madrasah | : | MI AL ISLAM CERME | | | Nomor Pokok Sekolah Nasional (NPSN ) | | | |
| 2. | Alamat Sekolah/Madrasah | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | a. | Jalan | | | | | : | Jl. RAYA KEDIRI NO 35 | | | 20574733 | | | |
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| | b. | Desa/Kelurahan | | : | CERME | | | Jenis Sekolah | | | | | | |
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| | | | | | | | | : | 1 | | 1. | Desa | | | | | | | | 2. | Kelurahan | | | | | | | | | | 2 | | 1. | SD | 2. | MI | | | |
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| | c. | Kategori Wilayah | | : | 4 | | 1. | Daerah Terpencil | | | | 2. | Daerah Perbatasan ( dengan negara lain ) | | | | | | | | | | | |
| | | | | | | | | | | | 3. | Daerah Transmigrasi | | | 4. | Tidak termasuk ketegori 1,2 atau 3 | | | | | | | | | | | | | |
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| | d. | Kecamatan | | | : | PACE | | | | | | | | | | | | | |
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| | e. | Kabupaten / Kota | | : | NGANJUK | | | | | | | | | | | | | |
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| | | | | | | | | | 1 | | 1. | Kabupaten | | | 2. | Kota | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | f. | Propinsi | | | | : | JAWA TIMUR | | | | | | | | | | | | | |
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| | g. | Kode Pos | | | : | 64472 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | h. | Kode Area / No. Telp. / Fax | | : | 0358 | 327321 | E-mail : | mi.alislam.cerme@gmail.com | / Website : | | | |
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| 3. | Status Sekolah | | | | | | : | 2 | | 1. Negeri | | | | 2. Swasta | | | | | | | | | | | | | | | | | | | | | |
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| 4. | Status Akreditasi Sekolah | | | | : | 4 | | 1. A | | | | | | 2. B | | | | | | | 3. C | | | | | 4. TT | | | | | | | | | |
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| 5. | Waktu Penyelenggaraan | | | | : | 1 | | 1. Pagi | | | | | 2. Siang | | | | | | 3. Kombinasi | | | | | | | | | | | | |
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| 6. | Gugus Sekolah | | | | | | : | 3 | | 1. Inti | | | | | | 2. Imbas | | | | | | 3. Belum Ikut | | | | | | | | | | | | |
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| 7. | Kategori Sekolah | | | | | | : | 1 | | 1. SD SPM (Standar Pelayanan Minimal) | | | 2. SD RSSN (Rintisan Sekolah Standar Nasional) | |
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| | | | | | | | | | | | | | | 3. SD SSN (Sekolah Standar Nasional) | | | 4. SD RSBI (Rintisan Sekolah Bertaraf Internasional) | |
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| | | | | | | | | | | | | | | 5. SD SBI (Sekolah Bertaraf Internasional) | | 6. SD-SMP Satu Atap | | | | | | | | | |
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| 8. | Apakah Sekolah ini telah melaksanakan Manajemen Berbasis Sekolah (MBS) ? | | | 1 | | 1. | Ya | | | | 2. | Tidak | | | | | | | | |
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| 9. | Kurikulum Yang Digunakan | | | : | 3 | | 1. Kurikulum 1994 | | 2. Kurikulum 2004 (KBK) | 3. KTSP | | | | | | | | | | | | | | |
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| 10. | Apakah Sekolah ini mempunyai koneksi internet ? | : | 2 | | | | 1. | Ya | | | | | | 2. | Tidak | | | | | | | | | | | | | | |
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| 11. | Apakah Sekolah ini menerima dana BOS ? | | | : | 1 | | | | 1. | Ya | | | | | | 2. | Tidak | | | | | | | | | | | | | | |
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| 12. | Apakah Identitas sekolah tahun ini sama dengan identitas tahun lalu ? Jika identitas sekolah tahun ini sama dengan tahun lalu, langsung mengisi butir B | |
| | Jika identitas sekolah tahun ini tidak sama dengan tahun lalu (ada perubahan) maka tulislah identitas sekolah tahun lalu dengan rincian di bawah ini. | | |
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| | a. | Nomor Statistik Sekolah | | | : | | | | | | | | | | | | | | | | | | | | | | | |
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| | b. | Nama Sekolah/Madrasah | | : | MI AL ISLAM CERME PACE | | | | | | | | | | |
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| | c. | Alamat Sekolah/Madrasah | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | - Jalan | | | | | | | : | Jl. Raya Kediri No. 35 | | | | | | | | | | |
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| | | - Desa/Kelurahan | | | | | : | Cerme | | | | | | | | | | |
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| | | - Kecamatan | | | | | | : | PACE | | | | | | | | | | |
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| | | - Kabupaten/Kota | | | | | : | NGANJUK | | | | | | | | | | |
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| | | - Propinsi | | | | | | | : | JAWA TIMUR | | | | | | | | | | |
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| | d. | Status Sekolah/Madrasah | | : | 2 | | 1. | Negeri | | 2. | Swasta | | | | | | | | | | | | | | | | | | | | | | | |
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B. | SISWA, KELAS (ROMBONGAN BELAJAR), DAN DAFTAR NILAI UJIAN SEKOLAH | | | | | | | | | | | | | | | | | | | |
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| 1. | Penerimaan Siswa Baru Tingkat I | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Asal | Rencana | Pendaftar | Siswa Diterima di Tingkat I | | | | | | | | | |
| Siswa | Penerimaan | L | P | L+P | L | P | L+P | | | | | | | | | |
| (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | | | | | | | | | |
| 1. Tamatan TK | | 10 | 10 | 20 | 10 | 10 | 20 | | | | | | | | | |
| 2. Bukan TK | | | | - | | | - | | | | | | | | | |
| Jumlah | | 10 | 10 | 20 | 10 | 10 | 20 | | | | | | | | | |
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