PELAKSANAAN PROGRAM PERBAIKAN
MATA PELAJARAN : ………………………………………………………………………….
KOMPETENSI DASAR : ………………………………………………………………………….
INDIKATOR : ………………………………………………………………………….
MATERI POKOK : ………………………………………………………………………….
KELAS / SEMESTER : ………………………………………………………………………….
TAHUN PELAJARAN : ………………………………………………………………………….
TANGGAL ULANGAN HARIAN :
………………………………………………………………………….
WAKTU PERBAIKAN :
………………………………………………………………………….
NO
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NAMA
SISWA
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NILAI
AWAL
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NILAI
PERBAIKAN
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NILAI
AKHIR
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BENTUK
PERBAIKAN
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I
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II
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III
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Saketi, ………………………………………
Mengetahui : Guru Mata
Pelajaran
-------------------------------------------- -------------------------------------------
NIP. NIP.
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