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FORMULIR

PENGAJUAN DOSEN PEMBIMBING


TUGAS AKHIR
Nama

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

NRP

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

Jumlah SKS ditempuh

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

No Telp / Hp

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

Alamat Email

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

Topik / Bidang Minat / Judul TA: ......................................................................................................


....
Tujuan ( Research Question yang akan di jawab, jika sudah ada )

....
....
Metodologi (jika sudah ada)

....
....
....
Usulan Dosen
Pembimbing ................................................................................................................................................
...................
Usulan Ko-Pembimbing

: ..................................................................................................................
Surabaya, .....

Mengetahui,
Calon Dosen Pembimbing

Diajukan oleh,

.
(NIP)
Syarat Pengajuan (Dicek oleh Petugas Akademik)

(Mahasiswa)

Lulus SKS ..............


Lulus Kerja Praktek / Sedang Kerja Praktek (coret salah satu)

Jurusan Teknik Industri


FTI ITS
2013

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