Agustus
2014
Hormat saya,
( MAHASISWA )
NIM
Mengetahui,
Kepala Desa
Dosen Pembimbing
Lapangan I
( ............................... )
Dosen Pembimbing
Lapangan II
( ..............................................
)
NIP. ........................
Dosen Pembimbing
Lapangan III
( ............................................
...... )
NIP. ..................................
( ..............................................
..... )
NIP. ..............................
Kepala P2KKN-LPMM
Universitas Diponegoro