New Student Registration Form

Please complete the information for the prospective student, parent/guardian, and supporting documents as required by official regulations. Once the form is submitted, you will receive a registration number to track the selection process via the “Check Status” page. Fields marked with an * are required.

Online Registration · School Year 2027/2028

Fill Out the Form Carefully; It Will Take About 10 Minutes

Have your family registration card, birth certificate, and report card ready
Active parent's cell phone number
PNG, JPG, or PDF files

★

Registration Process

Regular

Scholarship Pathways

Tahfidz Scholarship Merit-Based Scholarships Khidmat Scholarship (Orphans) Residency Scholarship (Local Residents)

The requirements and benefits for each admission track are listed on the PPDB page. View admission requirements

Prospective Student Information

All fields are required, except those marked (Optional).

Full Name *

Nickname *

Religion *

Place of Birth *

Date of Birth *

NISN *

10 numbers.

NIK *

16 digits, as listed on the Family Card.

Child No. *

From … Brothers and Sisters *

Full Address *

Village/Neighborhood *

Subdistrict *

Regency/City *

Province *

ZIP Code *

Prospective Student's Cell Phone Number *

Education History

Elementary School/Islamic Elementary School of Origin *

Address of Home School *

Year of Graduation / Current Grade *

Diploma Number / Certificate Number (Optional)

Fill this in once it is published (6th-grade students usually don’t have it yet).

Parent/Guardian Information

Information about the father and mother must be provided, including an active cell phone number or WhatsApp number so the organizing committee can contact them. Guardian information is required only if applicable.

Father

Father's Name *

Dad's Job *

Dad's Cell Phone/ WhatsApp Number *

Mother

Mother's Name *

Mom's Job *

Your mother's cell phone number or WhatsApp number *

Guardian (Optional)

Guardian's Name (Optional)

Relationships with Prospective Students (Optional)

Guardian's Cell Phone/ WhatsApp Number (Optional)

Address of Parents/Guardians (If Different) (Optional)

Interest, Readiness, and Program Information

Program of Interest (Select One) *

Tahfidz Al-Qur'an Academic Youth/Physical Kesamaptaan

Al-Qur'an Memorization Estimates

Not Yet Available Already Available (Juz) Other Letters/Goals

Al-Qur'an Reading Skills

Basics Smooth Need Guidance on Tajwid/Makhraj

Achievements (If Any)

Special Needs / Important Information

Scholarship / Academic Achievement Information

General Provisions: 1. Applicants must submit supporting documentation (certificates, diplomas, or a death certificate). 2. Scholarship recipients must maintain their academic performance and progress in memorizing the Al-Qur'an each semester to continue receiving the scholarship. Submitting an application does not guarantee automatic approval of the scholarship; requirements, quotas, and the form of assistance are subject to the official regulations of the committee.

Explanation / Supporting Documents

Supporting Documents

Upload the following photos or scanned documents (PNG, JPG, JPEG, or PDF; max. 4 MB per file). Files marked with an * are required. The type, number, and final format will be as announced officially by the organizing committee.

Family Card (KK) *

Copy.

Drag & Drop berkas Family Card (KK) Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Birth Certificate *

Copy.

Drag & Drop berkas Birth Certificate Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

NISN / Student ID Card (Optional)

A copy, if available.

Drag & Drop berkas NISN / Student ID Card Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Elementary School/Islamic Elementary School Report Card *

Report cards for grades 4, 5, and 6 (first semester).

Drag & Drop berkas Elementary School/Islamic Elementary School Report Card Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Passport-Sized Photo of Prospective Students *

Wearing your original school uniform; 3x4 size.

Drag & Drop berkas Passport-Sized Photo of Prospective Students Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Syahadah / Tahfidz Certificate *

Proof of having memorized at least 2 juz.

Drag & Drop berkas Syahadah / Tahfidz Certificate Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Certificates / Awards *

First, second, or third place at the district level (science, sports, or arts competitions).

Drag & Drop berkas Certificates / Awards Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Certificate of a Parent's Death *

Proof of being an orphan.

Drag & Drop berkas Certificate of a Parent's Death Here, or Click to Select PNG, JPG, JPEG, or PDF · max. 4 MB

Statement from Parents/Guardians and Prospective Students

Sebelum mencentang, baca duluAnda sudah membaca . ✓ Sudah dibaca

I hereby declare that the information provided in this form is true and accurate. * I agree to submit the required documents and to follow the selection process and enrollment requirements officially announced by the admissions committee. * I understand that completing this form does not constitute proof of acceptance as a student. * I have read and agree to the school’s rules and regulations as well as the disciplinary sanctions outlined in the terms and conditions. *

Once submitted, you will receive a registration number.

Filling Progress

Documents You Need to Prepare

Family Card (KK)
Copy.
Birth Certificate
Copy.
NISN / Student ID Card
A copy, if available.
Elementary School/Islamic Elementary School Report Card
Report cards for grades 4, 5, and 6 (first semester).
Passport-Sized Photo of Prospective Students
Wearing your original school uniform; 3x4 size.
Syahadah / Tahfidz Certificate
Proof of having memorized at least 2 juz.
Special Tahfidz Scholarship
Certificates / Awards
First, second, or third place at the district level (science, sports, or arts competitions).
Special Merit-Based Scholarships
Certificate of a Parent's Death
Proof of being an orphan.
Special Khidmat Scholarship (Orphans)

The type, number, and final format will be as announced officially by the organizing committee.

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