DEPARTEMEN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS INDONESIA

FAKULTAS TEKNIK
DEPARTEMEN TEKNIK INDUSTRI
KAMPUS BARU UI DEPOK 16424
TEL / FAX: 62-21-78888805, 62-21-78884805

Revisi per 21 Jan. 2014

SKR01.1
Formulir Pengajuan

Proposal Mengambil Skripsi

Nama Mahasiswa

: ____________________________________

NPM

: ____________________________________

Tahun Angkatan

: ____________________________________

Nomor Tlp / Hp

: ____________________________________ Email : ________________________

Bidang Peminatan :
(1) Statistik dan Sistem Kualitas

(2) Programa Matematik/Riset Operasi

(3) Sistem Produksi

(4) Rekayasa Sistem

(5) Sistem Manusia, Kerja dan Organesasi

(6) Sistem Ekonomi & Manajemen Industri

(7) Product Design

(8) Sistem Informasi

(9) Lain--lain

Tema Skripsi :
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Pilihan Dosen Pembimbing :

(1) _____________________________________________
(2) _____________________________________________

DEPARTEMEN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS INDONESIA

FAKULTAS TEKNIK
DEPARTEMEN TEKNIK INDUSTRI
KAMPUS BARU UI DEPOK 16424
TEL / FAX: 62-21-78888805, 62-21-78884805

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SK01 hal 2

DISKRIPSI SKRIPSI
Tema :
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Definisi Masalah/Maksud/Tujuan :
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Teori Prinsip/Teknik/Metodologi :
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Out put
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DEPARTEMEN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS INDONESIA

FAKULTAS TEKNIK
DEPARTEMEN TEKNIK INDUSTRI
KAMPUS BARU UI DEPOK 16424
TEL / FAX: 62-21-78888805, 62-21-78884805

SKR01-hal3
Uraian Singkat Pengerjaan (bisa menggunakan halaman tambahan) :
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Nama Mahasiswa :

Tanda Tangan :

Tanggal :

__________________________

_________________

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DEPARTEMEN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS INDONESIA

FAKULTAS TEKNIK
DEPARTEMEN TEKNIK INDUSTRI
KAMPUS BARU UI DEPOK 16424
TEL / FAX: 62-21-78888805, 62-21-78884805

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