SATUAN PENDUKUNG (SATKUNG)
PELAYANAN KONSELING
A. Jenis
Satuan Pendukung : Kunjungan Rumah
B. Topik
Permasalahan/Bahasan : .....................................................................
C. Bidang
Bimbingan : ....................................................................
D. Fungsi
Kegiatan : .....................................................................
E. Tujuan
Kegiatan/Hasil yang
ingin dicapai :
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F. Subyek
yang Mengalami Masalah : .....................................................................
G. Gambaran
Ringkas Masalah :
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H. Tempat
Penyelenggaraan : .....................................................................
I. Waktu/Semester :
.....................................................................
J. Penyelenggara
Kegiatan : .....................................................................
K. Anggota
keluarga yang akan dikunjungi dan apa yang diharapkan dari mereka masing-masing
:
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L. Bahan dan Keterangan yang Dibawa
dalam Kunjungan :
1. ..............................................................................................................................
2. ..............................................................................................................................
3. ..............................................................................................................................
M. Penggunaan Hasil Kunjungan : .....................................................................
N. Rencana Penilaian dan Tindak
Lanjut Kegiatan :
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O. Keterkaitan Kegiatan dengan
Layanan/Kegiatan Pendukung lainnya :
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P. Cacatan Khusus :
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Mengetahui
Kepala
Sekolah Guru
Pembimbing
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NIP. NIP.
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