FORMAT PERBAIKAN DAN PENGAYAAN

REMEDIAL/PERBAIKAN

Nama Sekolah                                     : .......................................................................................

Mata Pelajaran                                    : .......................................................................................

Kelas / Smester                                   : .......................................................................................

Ulangan Ke                                         : .......................................................................................

Tanggal Ulangan                                 : .......................................................................................

Bentuk Soal                                        : .......................................................................................

Jumlah Soal                                         : .......................................................................................

Materi Ulangan ( KD/ Indikator )       : .......................................................................................

                                                            : .......................................................................................

                                                            : .......................................................................................

                                                            : .......................................................................................

                                                            : .......................................................................................

Rencana Ulangan Ulang                     : .......................................................................................

KKM Mata Pelajaran                          : .......................................................................................

No	Nama Peserta Didik	Nilai Ulangan	KD/ Indikator Yang Tak Dikuasai	No. Soal Yang Dikerjakan Dalam Tes Ulang	Hasil

Keterangan :

1. Pada kolom nomor soal yang akan dikerjakan, diambil dari nomor-nomor soal yang tidak dapat dikerjakan dan yang sesuai dengan indikatornya masing-masing.
2. Pada kolom hasil diisi nilai hasil ulangan ulang, walaupun nlai yang nantinya diolah adalah sebatas nilai ketuntasan ( KKM )

Mengetahui                                                                 Braja Selebah, .............................. 2013

Kepala SDN .....................................                          Guru Kelas / Mapel

..........................................................                          ..............................................................

NIP                                                                             NIP

PROGRAM PENGAYAAN

Nama Sekolah                                     : .......................................................................................

Mata Pelajaran                                    : .......................................................................................

Kelas / Smester                                   : .......................................................................................

Pengayaan Ke                                     : .......................................................................................

Tanggal Pengayaan                             : .......................................................................................

Bentuk Pengayaan                              : .......................................................................................

Materi Pengayaan                               : .......................................................................................

Materi Ulangan ( KD/ Indikator )       : .......................................................................................

                                                            : .......................................................................................

                                                            : .......................................................................................

                                                            : .......................................................................................

Rencana Pengayaan                            : .......................................................................................

KKM Mata Pelajaran                          : .......................................................................................

No	Nama Peserta Didik	Nilai Ulangan	Bentuk Pengayaan

Keterangan :

1. Pada kolom bentuk pengayaan disi dengan kegiatan yang dapat mengembangkan potensi siswa dengan memanfaatkan media yang ada, dapat melalui tugas kelompok,tutor sebaya,latihan-latihan atau mengerjakan tugas portofolio.

Mengetahui                                                                 Braja Selebah, .............................. 2013

Kepala SDN .....................................                          Guru Kelas / Mapel

..........................................................                          ..............................................................

NIP                                                                             NIP