FAKULTAS TEKNIK
SK. MENDIKNAS RI Nomor 158/E/O/2011, Tanggal 2 Agustus
2011
Jalan Ciwaru II No. 73 Kota Serang – Banten Telp. (0254) 217066,
268045 Fax. (0254) 209583
PENGAJUAN JUDUL BIMBINGAN Nomor Dokumen
FORMULIR SKRIPSI F/BD/01
NAMA : ..................................................................................................................................
NPM : ..................................................................................................................................
TTL : ..................................................................................................................................
FAKULTAS / PRODI : ..................................................................................................................................
ALAMAT LENGKAP : ..................................................................................................................................
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NO. TELP / HP : ..................................................................................................................................
Mengajukan bimbingan Skripsi dengan Rencana Judul sebagai berikut :
PARAF
PEMBIMBING,
NO RENCANA JUDUL SKRIPSI KA.
I & II
PRODI
1.
2.
3.
STATUS
PARAF
NO BERKAS YANG HARUS DILAMPIRKAN
Ya Tidak PETUGAS
Bukti telah menempuh minimal SKS & IPK, 135-144 SKS, IPK >
3.
2.01, Tidak ada Nilai D dan E.
Serang, .................................2020
Disetujui,
Ka. Prodi , Mahasiswa/i
............................................ ...........................................
Tanda tangan & nama jelas Tanda tangan & nama jelas