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8/16/2019 Lampiran II a Iic Dupak
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SALINAN -
DAFTAR USUL
PENETAPAN ANGKA KREDIT PENGAWAS SEKOLAH MUDA
NOMOR :
Instansi : ……………………………….. Masa penilaian Blan…………..s!" ………………
NO KETERANGAN PERORANGAN
1 N a m a
2 N I P
3 NUPTK `
4 Nomo S!" Ka#$ P!%a&a"
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10 Ma.a K!5a Go+o*%a*Lama
Ba$
11 !*". P!%a&a. S!o+a,
12 U*"# K!5a
UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
1 2 3 4 ' 6
I UNSUR UTAMA
& PENDIDIKAN
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8/16/2019 Lampiran II a Iic Dupak
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UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
1 2 3 4 ' 6
' PENGAWASAN AKADEMIK DAN MANA%ERIAL
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UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
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UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
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8/16/2019 Lampiran II a Iic Dupak
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SALINAN -
DAFTAR USUL
PENETAPAN ANGKA KREDIT PENGAWAS SEKOLAH MAD#A
NOMOR :
Instansi : ……………………………….. Masa penilaian Blan…………..s!" ………………
NO KETERANGAN PERORANGAN
1 N a m a
2 N I P
3 NUPTK `
4 Nomo S!" Ka#$ P!%a&a"
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Ba$
11 !*". P!*%a&a. S!o+a,
12 U*"# K!5a
UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
1 2 3 4 ' 6
I UNSUR UTAMA
& PENDIDIKAN
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UNSUR #ANG DINILAI
NO UNSUR$ SUB UNSUR DAN BUTIR KEGIATAN
ANGKA KREDIT MENURUT
INSTANSI PENGUSUL TIM PENILAI
LAMA BARU %UMLAH LAMA BARU %UMLAH
1 2 3 4 ' 6
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