LEMBAGA PEMBINAAN DAN PENGEMBANGAN TAMAN
KANAK-KANAK AL-QUR’AN
BADAN KOMUNIKASI PEMUDA DAN REMAJA MASJID INDONESIA
LPPTKA-BKPRMI KAB. BANYUWANGI
Alamat : Jl. Basuki Rahmat 21 Telp. (0333) 428708,
425700 Banyuwangi
Nomor :
Lampiran :
H a l :
Permohonan
Nomor Unit
Kepada Yth
Direktur LPPTKA-BKPRMI
Kabupaten Banyuwangi
Di –
Banyuwangi
Bismillaahirrohmaanirrohiim
Assalamu’alaikum
Wr. Wb.
Dalam
rangka meningkatkan upaya pengelolaan Pendidikan Al-Qur’an di daerah kami dan
setelah melengkapi persyaratan-persyaratan pembukaan TK / TP Al-Qur’an BKPRMI,
maka kami mohon kepada Bapak untuk memberikan nomor unit TK / TP Al-Qur’an kami
dan selanjutnya membinanya.
Demikian
permohonan ini, atas perhatiannya diucapkan terima kasih. Semoga Allah SWT
memberikan kelancaran dakwah kita bersama, AMIN.
Billahittaufiq wal hidayah
Wassalamu’alaikum Wr. Wb.
Banyuwangi, ......................
Pengelola Direktur
TK / TP Al-Qur’an
.................................... .......................................
LEMBAGA PEMBINAAN DAN PENGEMBANGAN TAMAN
KANAK-KANAK AL-QUR’AN
BADAN KOMUNIKASI PEMUDA DAN REMAJA MASJID INDONESIA
LPPTKA-BKPRMI KAB. BANYUWANGI
Alamat : Jl. Basuki Rahmat 21 Telp. (0333) 428708,
425700 Banyuwangi
KEADAAN TAMAN PENDIDIKAN AL-QUR’AN
BULAN :
...................................................................
1. Nama Lembaga Pengelola : ................................................................................................................
2. Nama Lembaga : ..............................................................................................................
3. Nomor Unit : ..............................................................................................................
4. Alamat Lengkap :
Jalan : ..............................................................................................................
RT / RW : ..............................................................................................................
Dusun : ..............................................................................................................
Desa / Kelurahan :
..............................................................................................................
Kecamatan :
..............................................................................................................
Kabupaten :
..............................................................................................................
Nomor Telepon :
..............................................................................................................
Nomor HP :
..............................................................................................................
5. Waktu
belajar : Pagi : Jam
........................................ s.d
....................................Wib
:
Siang : Jam
........................................ s.d ...................................Wib
:
Sore : Jam
........................................ s.d
..................................Wib
:
Malam : Jam
........................................ s.d
.................................. Wib
6. Jumlah
Santri :
a.
TK Al-Qur’an : Putra
..........................................................................................anak
Putri
...........................................................................................anak
b.
TP Al-Qur’an : Putra ...........................................................................................anak
Putri
...........................................................................................anak
c.
TQ Al-Qur’an : Putra
..........................................................................................anak
Putri
...........................................................................................anak
Jumlah
Keseluruhan :
.....................................................................................................anak
7. Nama
Kepala Lembaga :
...........................................................................................
Jumlah
Ustadz : Putra ....................................................................................ustadz/dzah
Putri
.....................................................................................ustadz/dzah
Nama
Ustadz / Ustadzah : ..............................................................................................
:
...........................................................................................
:
............................................................................................
:
.............................................................................................
:
.............................................................................................
:
..............................................................................................
Banyuwangi, .........................................................
Direktur TK / TP Al-Qur’an
................................
...........................................................
Lampiran :
SUSUNAN KEPENGURUSAN
1. Ketua Lembaga Pengelola :
...................................................................................................
2. Direktur TPA / TPQ :
..................................................................................................
3. Wakil Direktur TPA / TPQ :
...................................................................................................
4. Bendahara :
.................................................................................................
5. Wakil Bendahara :
.................................................................................................
6. Kepala Tata Usaha :
................................................................................................
7. Wali Kelas Santri :
1. ............................................................................................
2. ...........................................................................................
3...........................................................................................
4. .......................................................................................
5. ...........................................................................................
6.
..........................................................................................
7. ...........................................................................................
8. ......................................................................................
9.
........................................................................................
10. ...................................................................................
8. Nama Ustadz dan Ustadzah :
1. ..........................................................................
: ditatar/belum
2. ..........................................................................
: ditatar/belum
3. ..........................................................................
: ditatar/belum
4.
..........................................................................
: ditatar/belum
5. ..........................................................................
: ditatar/belum
6. ..........................................................................
: ditatar/belum
7. ..........................................................................
: ditatar/belum
8. ..........................................................................
: ditatar/belum
9.
..........................................................................
: ditatar/belum
10. .........................................................................: ditatar/belum
9. Ketua POS (Persatuan Orang Tua Santri) :1...............................................................................
Banyuwangi,
.................................
Pengelola Direktur
TK / TP Al-Qur’an
...................................... ..........................................
