Kode Dok : F-KPS-1305

Revisi :1

PERSETUJUAN PENGAJUAN JUDUL

PROPOSAL SKRIPSI
T.A. 20__ / 20__

Yth.
Ketua Program Studi ……………………..

Dengan ini saya :

Nama : ………………………………………….
NPM : ………………
Program Studi : ……………………………..
Jumlah SKS yang telah ditempuh : ………. SKS
IPK : ……….
Nomor Telepon/HP : …………………………

Mengajukan usulan judul proposal skripsi dengan :

1. Topik (Bahasa Indonesia) : …………………………………………………………………
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Topik (Bahasa Inggris) : …………………………………………………………………
…………………………………………………………………

2. Topik (Bahasa Indonesia) : …………………………………………………………………

…………………………………………………………………
Topik (Bahasa Inggris) : …………………………………………………………………
…………………………………………………………………
Tempat Penelitian : …………………………………………………………………
Dosen Pembimbing*) : …………………………………………………………………

Bandarlampung, .........................
Ketua Program Studi, Pengusul,

_____________________ _____________________
NIK. NPM.

*) diisi oleh Ketua Program Studi

Pemaparan Judul 1 : ..................................................................................................................
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Pengusul, ………………

_____________________.
NPM.
Pemaparan Judul 2 : ..................................................................................................................
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Pengusul, ………………

_____________________.
NPM.