Anda di halaman 1dari 1

Pendaftaran Peserta Studio Tugas Akhir

PROGRAM STUDI TEKNIK SIPIL S1


Nama : ...........................................................................................
Alamat : ...........................................................................................
...........................................................................................
...........................................................................................
Telpn / HP : ...........................................................................................
NIM : ...........................................................................................
Program : Proposal / Tugas Akhir / Proposal + Tugas Akhir (coret yang tidak perlu)
Judul : ...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
Pembimbing I : ....................................................... lama :....................................
Pembimbing II : ....................................................... lama : ...................................
Bidang Keahlian : ...........................................................................................

Di cek oleh petugas


Kelengkapan Berkas *): Keterangan :
1. Surat Permohonan mem-program Proposal / Tugas Akhir (Sudah / Belum)
2. Lembar DPA (check Recording) (Sudah / Belum)
3. Foto Copy Lembar Pengesahan dan Persetujuan Proposal (Khusus Peserta Tugas Akhir) (Sudah / Belum)
4. Foto Copy Lembar Cek Tugas (Sudah / Belum)
5. Slip Pembayaran Virtual Account (ASLI) (Sudah / Belum)
NO KEGIATAN JUMLAH
Studio Tugas Akhir Teknik Sipil S-1
1 a. Program Proposal Rp. 125.000,-
b. Program Tugas Akhir Rp. 300.000,-
2 Seminar Proposal Rp. 100.000,-
3 Seminar Hasil Rp. 100.000,-
4 Ujian Tugas Akhir Rp. 200.000,-
6. Khusus peserta yang melanjutkan skripsi. Jika sudah melakukan SEMHAS, wajib melampirkan Foto copy catatan revisi
SEMHAS dari pembahas