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    Borang PPW1

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    Rizman Dain
    This document is an application form for exemption from compulsory education to conduct home schooling. It requests information such as the applicant's details, child's details, home schooling details including curriculum, assessment methods, timetables and teachers' qualifications. Supporting documents like identity cards and academic certificates must be attached. The applicant acknowledges the truth of the statements and agrees to the terms of home schooling.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Borang PPW1

    Uploaded by

    Rizman Dain
    356 views4 pages
    This document is an application form for exemption from compulsory education to conduct home schooling. It requests information such as the applicant's details, child's details, home schooling details including curriculum, assessment methods, timetables and teachers' qualifications. Supporting documents like identity cards and academic certificates must be attached. The applicant acknowledges the truth of the statements and agrees to the terms of home schooling.

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    borang home schooling

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    Borang_PPW1

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    This document is an application form for exemption from compulsory education to conduct home schooling. It requests information such as the applicant's details, child's details, home schooling details including curriculum, assessment methods, timetables and teachers' qualifications. Supporting documents like identity cards and academic certificates must be attached. The applicant acknowledges the truth of the statements and agrees to the terms of home schooling.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    356 views4 pages

    Borang PPW1

    Uploaded by

    Rizman Dain
    This document is an application form for exemption from compulsory education to conduct home schooling. It requests information such as the applicant's details, child's details, home schooling details including curriculum, assessment methods, timetables and teachers' qualifications. Supporting documents like identity cards and academic certificates must be attached. The applicant acknowledges the truth of the statements and agrees to the terms of home schooling.

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    of 4

    BORANG PPW 1

    PERMOHONAN
    PENGECUALIAN DARIPADA MENGIKUTI PENDIDIKAN WAJIB
    BAGI MENJALANKAN PERSEKOLAHAN DI RUMAH
    (HOME SCHOOLING)

    1. BUTIRAN SEKOLAH:

    a. Nama : ……………………………………………………………………………………………

    b. Hubungan dengan kanak-kanak : ……………………………………………………………..

    c. Pekerjaan : ……………………………………………………………………………………….

    d. Alamat majikan : …………………………………………………………………………………

    …………………………………………………………………………………

    …………………………………………………………………………………

    e. Alamat rumah : …………………………………………………………………………………..

    …………………………………………………………………………………..

    …………………………………………………………………………………..

    f. No. Telefon : …………………………………. (R)

    …………………………………. (H/P)

    …………………………………. (Pej.)

    2. BUTIRAN KANAK-KANAK :

    a. Nama kanak-kanak : ……………………………………………………………………………….

    b. Tarikh Lahir : …………………………………… c. No. Sijil Lahir : ……………..………….

    d. Nama dan alamat sekolah kanak-kanak didaftarkan :

    ………………………………………………………………………………………………………..

    ……………………………………………………………………………………………………….

    e. Sedang mengikuti home schooling : Ya / Tidak

    Jika Ya, tempoh yang sedang diikuti : …………. tahun


    3. BUTIRAN HOME SCHOOLING :

    a. Alamat premis home schooling : …………………………………………………………………

    ………………………………………………………………..

    …………………………………………………………………

    b. Tenaga pengajar :

    i. Nama : …………………………………………………………………………………………

    Kelayakan : ……………………………………………………………………………………

    Hubungan dengan murid : ……………………………………………………………………

    ii. Nama : …………………………………………………………………………………………

    Kelayakan : ……………………………………………………………………………………

    Hubungan dengan murid : ……………………………………………………………………

    iii. Nama : …………………………………………………………………………………………

    Kelayakan : ……………………………………………………………………………………

    Hubungan dengan murid : ……………………………………………………………………

    (Sila lampirkan sekiranya tenaga pengajar yang terlibat lebih dari yang tersenarai di atas)

    c. Tempoh waktu pengajaran :

    i. …………/jam sehari.

    ii. …………/jam seminggu.

    iii. …………/jam sebulan.

    d. Kurikulum yang digunakan dan mata pelajaran yang diajar (Sila lampirkan)

    e. Kaedah penilaian kemajuan murid (Sila lampirkan)

    f. Laporan kemajuan murid (Sila lampirkan)

    g. Jadual waktu harian/mingguan (Sila lampirkan)

    h. Salina asal laporan doctor (jika berkenaan) (Sila lampirkan)


    i. Lain-lain : Sila nyatakan dan lampirkan :

    i. …………………………………………………………………

    ii. …………………………………………………………………

    4. SEBAB-SEBAB KHAS MENJALANKAN HOME SCHOOLING :

    ………………………………………………………………………………………………………………

    ……………………………………………………………………………………………………………..

    ……………………………………………………………………………………………………………..

    ……………………………………………………………………………………………………………..

    5. Dokumen berikut dilampirkan bersama boring ini *(Sila tandakan √ bagi “Ada”, X bagi “Tiada”
    dan TB bagi “Tidak Berkenaan”) :

    Bil. Dokumen √ / X / TB

    1 Salinan Kad Pengenalan Bapa (depan & belakang)

    2 Salinan Kad Pengenalan Ibu (depan & belakang)

    3 Salinan Sijil Lahir Anak (depan & belakang)

    4 Salinan Sijil Akademik Tenaga Pengajar (i)

    5 Salinan Sijil Akademik Tenaga Pengajar (ii)

    6 Salinan Sijil Akademik Tenaga Pengajar (iii)

    7 Salinan kurikulum yang digunakan

    8 Senarai mata pelajaran yang diajar

    9 Kaedah penilaian kemajuan murid

    10 Laporan kemajuan murid

    11 Jadual waktu mingguan/harian

    12 Salina asal laporan doktor

    13 Dokumen lain jika berkenaan


    6. PENGAKUAN

    Saya ……………………………………..……………… No. KP : ……………………………………


    (Nama Penuh)

    a. Memohon untuk :

    i. dikecualikan daripada mengikuti pendidikan wajib; dan

    ii. menjalankan home schooling

    ke atas anak saya / di bawah jagaan saya yang bernama ………………………………

    ……………………… yang beralamat di ……………………...........................................

    …………………………………………………………………………….……………..; dan

    b. Dengan sesungguhnya mengaku bahawa :-

    i. pernyataan-pernyataan yang terkandung dalam borang permohonan ini dan


    dokumen-dokumen yang dilampirkan adalah benar sepanjang pengetahuan
    saya; dan

    ii. tandatangan pada borang ini adalah dengan tulisan tangan saya.

    Tarikh : …………………………. Ditandatangani dan diakui oleh saya,

    …………………………………………

    Nama (dengan HURUF BESAR) : ………………………………………………………….

    No. Kad Pengenalan : …………………………………………………………..

    Alamat : .…………………………………………………………..

    …………………………………………………………….

    …………………………………………………………….

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