PROPOSAL PERMOHONAN BANTUAN

DANA LOMBA
“judul kegiatan”
Tanggal Kegiatan Lomba

Universitas Tujuan Lomba

Logo Kampus

Nama Universitas
Kota Universita
Tahun
 PROPOSAL PENDELEGASIAN
(Judul Kegiatan)
Tempat, Tgl. Kegiatan

A. LATAR BELAKANG

1. Latar Belakang Partisipasi Kegiatan

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2. Latar Belakang Kegiatan
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B. TUJUAN KEGIATAN
1. Tujuan Umum
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2. Tujuan Khusus
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C. SASARAN KEGIATAN
Sasaran kegiatan “Judul Kegiatan” adalah Mahasiswa /mahasiswi Se- Indonesia
D. JADWAL KEGIATAN
NO KEGIATAN TANGGAL
1 - -
2 - -
3 - -
4 - -
5 - -

E. ALUR REGISTRASI
1. ..............................................................................................................................................
2. ...............................................................................................................................................
3. ...............................................................................................................................................

F. BENTUK KEGIATAN
Bentuk dari kegiatan ini merupakan sebuah kompetisi yang memberikan kesempatan
untuk mahasiswa/i mempresentasikan atau memaparkan .... dari sudut pandang disiplin
ilmu terdiri dari ..........

G. TEMA KEGIATAN
“ ................................................................................................................................................ “
H. PESERTA DELEGASI INSTITUT AGAMA ISLAM NEGERI
Pendelegasian Lomba“Judul Kegiatan” dilakukan melalui pendaftaran dan pengisian
formulir lomba. Untuk universitas yang merupakan universitas delegasi resmi Judul
Kegiatan seperti Nama Kampus, pengiriman delegasi dalam event ini sebanyak ...Orang/
Tim yang terdiri dari ... orang. Berdasarkan penilaian, seleksi, proposal dan keputusan juri
“Judul Kegiatan”

NO NAMA NIM JURUSAN NO.HP

1. - - - -
2. - - - -
3. - - - -

I. MISI PENDELEGASIAN (NAMA KAMPUSMU)

Menjadi perwakilan (Nama Universitasmu) pada khususnya dan (Kotamu) pada
umumnya dalam acara“Judul Kegiatan”Serta Membawa nama baik serta pencitraan
terhadap (Nama Kampsmu) yang telah memberi bantuan dana.
J. ANGGARAN DANA
(Terlampir)

K. PENUTUP
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LAMPIRAN DANA

NO. ITEM BANY SATUAN HARGA HARGA

PEMBIAYAAN AKNY A SATUAN TOTAL

1 Registrasi
2 Transpotasi
a.kota Asal-Tujuan
b.Tujuan-Kota
Asal
3 Konsumsi
(Banyaknya) kali
makan (Untuk x hari)
4 Penginapan
(Untuk x hari)
5 Biaya Lain-Lain
TOTAL Rp..........

Total dana yang dibutuhkan untuk pengiriman delegasi (Nama kampusmu) untuk “Nama

Kegiatan” adalah Rp ............. Terbilang: “...................................”