KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN

FAKULTAS PERTANIAN
Jl. dr. Soeparno Telp. (0281) 638791 Purwokerto 53123

SYARAT PENDADARAN

Nama Mahasiswa :...................................................................................................

NIM :...................................................................................................
Jurusan :...................................................................................................
Program Studi :...................................................................................................

No Syarat - syarat Keterangan

1 Foto Copy Surat Tanda Bukti Pembayaran SPP
2 Surat Keterangan Selesai Praktek Penelitian
3 Tanda Terima Skripsi dari Perpustakaan Unsoed dan Fakultas
4 Tanda Terima Skripsi dari Pembimbing I dan Pembimbing II
5 Surat Keterangan Bebas Laboratorium
6 Biodata Alumni ( rangkap 3 )
7 Formulir Pendaftaran / Persyaratan Ujian Akhir Tingkat Sarjana ( Rangkap 3 )
8 Menyerahkan Skripsi dan CD Skripsi
9 Foto Copy Transkrip Sebanyak 8 Lembar
10 Foto Ukuran 3 x 4 ( 2 lbr ) Hitam Putih, dan Ukuran Kartu Pos 1 Lembar (bebas )
11 Ringkasan dan Summary Masing-masing Sebanyak 8 Lembar
12 Usulan Penelitian dan PKL ( Tanda Terima dari Masing-masing Program Studi )
13 Foto Copy Toefl

Purwokerto,................................20....
Subag Akademik dan Kemahasiswaan.

.........................................................
NIP.
Catatan : Stopmap Sesuai Program Studi/ Jurusan
Agroteknologi : Warna Hijau
Tek. Pert. : Warna Biru
Sosek : Warna Merah

SURAT KETERANGAN
SELESAI PRAKTEK PENELITIAN
Yang bertanda tangan di bawah ini menerangkan bahwa :

Nama : ....................................................................................................................
NIM : ....................................................................................................................
Program Studi : ....................................................................................................................
Jurusan : ....................................................................................................................

Telah selesai melaksanakan Praktek Penelitian dengan judul :

......................................................................................................................................................................

.....................................................................................................................................................................

.....................................................................................................................................................................

.....................................................................................................................................................................

......................................................................................................................................................................

Mulai Tanggal : .................................................................................

Sampai Dengan : .................................................................................
Di : .................................................................................
Kecamatan : .................................................................................
Kabupaten : .................................................................................

Demikian untuk diketahui dan digunakan seperlunya.

Diketahui :

Pembimbing I Pembimbing II

............................................................... ...............................................................
NIP....................................................... NIP.......................................................

TANDA TERIMA SKRIPSI

Yang Bertanda Tangan Dibawah Ini :

Nama :................................................................

NIM :................................................................

Telah Menyerahkan Skripsi Kepada Pembimbing I Dengan Judul :

...................................................................................................................................

...................................................................................................................................

...................................................................................................................................

...................................................................................................................................

Demikian untuk dapat digunakan sebagai persyaratan pendaftaran pendadaran

Purwokerto, .................................20...
Yang menerima, Yang menyerahkan
Pembimbing I

NIP NIM

TANDA TERIMA SKRIPSI

Yang Bertanda Tangan Dibawah Ini :

Nama :................................................................

NIM :................................................................

Telah Menyerahkan Skripsi Kepada Pembimbing II Dengan Judul :

...................................................................................................................................

...................................................................................................................................

...................................................................................................................................

...................................................................................................................................

Demikian untuk dapat digunakan sebagai persyaratan pendaftaran pendadaran

Purwokerto, .................................20...
Yang menerima, Yang menyerahkan
Pembimbing II

NIP NIM

FORMULIR PERSYARATAN UJIAN AKHIR TINGKAT SARJANA

FAKULTAS PERTANIAN

1. Nama Lengkap : ...........................................................................................

2. Nomor Induk Mahasiswa : ...........................................................................................
 3. Program Studi : ...........................................................................................
4. Tempat Tgl. Lahir : ...........................................................................................
5. Masuk Fak. Pertanian : ...........................................................................................
6. Alamat Kost : ...........................................................................................
7. Alamat Rumah : ...........................................................................................
8. Skripsi : ...........................................................................................
Mulai Tanggal/Bulan : ...........................................................................................
Selesai s/d Ujian Skripsi : ...........................................................................................
Judul : ...........................................................................................
...........................................................................................
Dosen Pembimbing I : ...........................................................................................
Dosen Pembimbing II : ...........................................................................................
9. Praktik Kerja Lapang : ...........................................................................................
Mulai Tgl / Bulan : ...........................................................................................
Selesai Ujian Tgl : ...........................................................................................
Judul : ...........................................................................................
...........................................................................................
Dosen Pembimbing : ...........................................................................................
10. Kuliah Kera Nyata : ...........................................................................................
Mulai Tanggal : ...........................................................................................
Selesai tanggal : ...........................................................................................
Nilai : ...........................................................................................
11. Lokasi Kuliah Kerja Nyata : ...........................................................................................
Desa : ...........................................................................................
Kecamatan : ...........................................................................................
Kabupaten : ...........................................................................................
12 . Dosen Pemb. Lapangan : ...........................................................................................
Kuliah Kerja Nyata : ...........................................................................................
13. IPK Sebelum Ujian Akhir : ...........................................................................................

Mengingat pentingnya data-data tersebut di atas sebagai bahan untuk pembuatan ijazah, maka
telah saya isi dengan sebenarnya. Apabila dikemudian hari ternyata palsu saya bersedian
menerima resikonya.

Purwokerto, ............................20......
Yang Membuat

............................................................
NIM
KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI
UNIVERSITAS JENDERAL SOEDIRMAN
FAKULTAS PERTANIAN
Jl. Dr. Soeparno Telp. (0281) 638791 Purwokerto 53123
Perihal : Surat keterangan bebas pinjaman laboratorium
Fakultas Pertanian Unsoed

Yth. Sub. Bagian Akademik dan Kemahasiswaan

Fakultas Pertanian Unsoed
Purwokerto

Yang bertanda tangan dibawah ini menerangkan bahwa :

Nama : ...................................................................................................
NIM : ...................................................................................................
Jurusan : ...................................................................................................
Program Studi : ...................................................................................................
Tingakat : ...................................................................................................

Telah menyelesaikan tugasnya, baik praktek laboratorium, lapangan dan sudah tidak lagi
mempunyai tenggungan / pinjaman alat-alat laboratorium Fakultas Pertanian Unsoed.
Kemudian harap menjadi maklum dan digunakan seperlunya.

1. Kepala Lab. Tanah/Sumberdaya Lahan 2. Kepala Lab. Perlindungan Tanaman

................................................................................... ............................................................................
3. Kepala Lab. Agronomi dan Hortikultura 4. Kepala Lab. Pemuliaan Tanaman dan
Bioteknologi

.......................................................................... .......................................................................
5. Kepala Lab. Perenc. Dan Pengembangan 6. Kepala Lab. Manajemen Agribisnis
Sumberdaya

.......................................................................... ..........................................................................
7. Kepala Lab. Teknologi Pengolahan 8. Kepala Lab. Manajemen Agroindustri

................................................................................... .............................................................................
9. Kepala Lab. Pangan dan Gizi 10. Kepala Lab. Mekanisasi Pertanian

................................................................................. .............................................................................
11. Kepala Lab. Komputer 12.

.................................................................................

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN
FAKULTAS PERTANIAN
Jl. Dr. Soeparno Telp. (0281) 638791 Purwokerto 53123

ISIAN BIODATA ALUMNI

Nama : ...........................................................................................
NIM : ...........................................................................................
Jenis Kelamin : ...........................................................................................
Tempat Lahir : ...........................................................................................
Tanggal Lahir : ...........................................................................................
Tanggal Lulus : ...........................................................................................
IPK : ...........................................................................................
Predikat : ...........................................................................................
Agama : ...........................................................................................
Alamat Rumah : ...........................................................................................
...........................................................................................
...........................................................................................
HP : ...........................................................................................
Tahun Masuk : ...........................................................................................
Fakultas : ............................................................................................
Jurusan : ............................................................................................
Prog. Studi : ............................................................................................
Lama Studi : ............................................................................................
Asal SLTA : ............................................................................................
Tgl Lulus SLTA : ............................................................................................
Nama Orang Tua : ............................................................................................
Pekerjaan Orang Tua : ...........................................................................................
Alamat Orang Tua : ...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
Judul Laporan : ...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
Pembimbing Utama : ...........................................................................................

Yang Membuat

.......................................

TANDA TERIMA USULAN PENELITIAN DAN PKL

1. Telah terima usulan penelitian dengan judul :

..........................................................................................................................................................
..........................................................................................................................................................
..........................................................................................................................................................
..........................................................................................................................................................
2. Laporan Praktik Kerja Lapangan dengan Judul :
 ..........................................................................................................................................................
..........................................................................................................................................................
..........................................................................................................................................................
..........................................................................................................................................................

Dengan demikian dapat digunakan sebagai persyaratan Untuk Pendadaran)

Purwokerto,
Yang menerima Yang Menyerahkan
Ketua Program Studi

............................................................................... ...............................................................................
NIP.

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN
FAKULTAS PERTANIAN
Jl. Dr. Soeparno Telp. (0281) 638791 Purwokerto 53123

SYARAT YUDISIUM

NAMA : ...................................................................................................................
NIM : ...................................................................................................................

PRODI / JURUSAN : ...................................................................................................................

NO. URUT : ...................................................................................................................

No. Pesyaratan Checklist

1 Foto Copy Kwitansi SPP
2 Transkrip 15 lembar
3 Surat keterangan unggah artikel ilmiah
4 Surat Keterangan Bebas Perpustakaan Unsoed dan Fakultas

Purwokerto,..............................................20........
Petugas Pendaftaran

............................................................
NIP.