Nama : ................................................................................................................
Alamat : ................................................................................................................
Pekerjaan : ................................................................................................................
Nama : ...............................................................................................................
NIM : ...............................................................................................................
Alamat : ...............................................................................................................
Agama : ...............................................................................................................
Dengan ini mengetahui, menyetujui dan memberi izin kepada anak kami tersebut di
atas untuk mengikuti pelaksanaan kegiatan Praktek Kerja Lapangan ( PKL ) Program
Studi Pendidikan Biologi Universitas Palangka Raya selama 7 hari di Surabaya – Malang –
Bali.
Palangka Raya,..............................2018
Orang Tua/Wali