BUKU KONSULTASI

SKRIPSI

Nama Perusahaan : _____ _________

Alamat Perusahaan : ______________

_______________________

Program Ganda
<<Jurusan - Jurusan>>
Universitas Bina Nusantara
 Data Pribadi Mahasiswa

Nim : ________________________________________

Nama Mahasiswa : ________________________________________

Alamat : ________________________________________

________________________________________

No. Telepon Rumah : ________________________________________

No. Telepon Kantor : ________________________________________
No. Ponsel : ________________________________________
Judul : ________________________________________
________________________________________
________________________________________

Mahasiswa,

Foto
mahasiswa

. .
Rencana Mulai : ___________________________

Rencana Selesai : ___________________________

Rencana Daftar Isi :

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Mengetahui,

Pembimbing 1 Pembimbing 2

( ___________________ ) ( ___________________ )
Tanggal : ____________ Tanggal : ____________
 Rencana Pelaksanaan

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 Absensi Konsultasi

Tgl Materi Saran Paraf

 Absensi Konsultasi

Tgl Materi Saran Paraf

CATATAN MAHASISWA
 Rekomendasi Dari Pembimbing
Periode I Semester Ganjil/Genap ______/______
(*)

Nim : ________________
Nama : _______________________________
Jurusan : _______________________________
Judul : ___________________________________________
___________________________________________
___________________________________________

O Dapat diterima.
O Belum selesai, dapat diperpanjang.
O Belum selesai sama sekali, harus mengajukan proposal baru.

Pembimbing 1 Pembimbing 2

( __________________ ) ( __________________ )
Tanggal : ____________ Tanggal : ____________

Ketua Jurusan/Sekretaris Jurusan (*) _________________________

( ________________________ )
Tanggal : ________________
(*)
coret yang tidak perlu
 Rekomendasi Dari Pembimbing
Periode II Semester Ganjil/Genap ______/______
(*)

Nim : ________________
Nama : _______________________________
Jurusan : _______________________________
Judul : ___________________________________________
___________________________________________
___________________________________________

O Dapat diterima.
O Belum selesai, dapat diperpanjang.
O Belum selesai sama sekali, harus mengajukan proposal baru.

Pembimbing 1 Pembimbing 2

( __________________ ) ( __________________ )
Tanggal : ____________ Tanggal : ____________

Ketua Jurusan/Sekretaris Jurusan (*) _________________________

( ________________________ )
Tanggal : ________________
(*)
coret yang tidak perlu
 Rekomendasi Dari Pembimbing
Periode III Semester Ganjil/Genap ______/______
(*)

Nim : ________________
Nama : _______________________________
Jurusan : _______________________________
Judul : ___________________________________________
___________________________________________
___________________________________________

O Dapat diterima.
O Belum selesai sama sekali, harus mengajukan proposal baru.

Pembimbing 1 Pembimbing 2

( __________________ ) ( __________________ )
Tanggal : ____________ Tanggal : ____________

Ketua Jurusan/Sekretaris Jurusan (*) _________________________

( ________________________ )
Tanggal : ________________
(*)
coret yang tidak perlu