LEMBAR KONTROL AKTIVITAS PKL (*)

TGL.

JENIS KEGIATAN

URAIAN
KEGIATAN

PEMBIMBING
NAMA
PARAF

(*)Diisi oleh Mahasiswa dan Industri

....., .2014
Pembimbing Industri,

Nama :
Jabatan: ..

LEMBAR BIMBINGAN (*)

NO.

TANGGAL

URAIAN

PARAF
PEMBIMBING

Denpasar, ........................................2014
Pembimbing,

(.............................................................)
NIP.......................................................

LEMBAR PENILAIAN INDUSTRI

Nama

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

NIM

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

Jurusan

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

Semester

; ...............................................................................

Tempat PKL ; ...............................................................................

Waktu PKL
NO.

; ...............................................................................
KOMPONEN PENILAIAN

Kemampuan Kerja (30%)

Disiplin (20%)

Komunikasi (15%)

Inisiatif (15%)

Kreativitas (10%)

Kerjasama (10%)

NILAI

Keterangan :
Sangat Baik

: 8,0 10

Cukup

Baik

: 7,0 7,9

Kurang

: 5,6 6,9
: <5,6

CATATAN :
................................................................................................................................................
................................................................................................................................................

..................................., ............................... 2014

Nama : ................................................................
Jabatan : ................................................................

SURAT KETERANGAN
Nomor : ........................................................................

Yang bertanda tangan di bawah ini :

Nama
Jabatan

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

Institusi/Perusahaan : .................................................................................
Alamat

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

Dengan ini menerangkan bahwa mahasiswa Politeknik Negeri Bali :

Nama

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

NIM.

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

Jurusan/Program Studi: .................................................................................

Semester

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

Memang benar telah melakukan Praktik Kerja Lapangan di perusahaan/instansi kami mulai
tanggal .....................s.d ...................pada bidang .......................................................................
Demikian surat keterangan ini dibuat untuk dapat dipergunakan sebagaimana mestinya.

....................................., .........................2014

(.....................................................................)