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KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS DIPONEGORO
FAKULTAS EKONOMIKA DAN BISNIS
Jl. Prof. H. Soedarto, SH. Tembalang Semarang 50275 Telp. (024) 76486851, 76486853; Fax : (024) 76486852
Jl. Erlangga Tengah No. 17 Semarang 50241 Telp. (024) 8449211, 8446409 Fax. (024) 8449212
Website : Akademik : www.simaweb.fe.undip.ac.id Email : feb@undip.ac.id

PENDAFTARAN WISUDA SARJANA


FAKULTAS EKONOMIKA DAN BISNIS UNDIP

Ditulis dengan Huruf Cetak

Nama (Sesuai akte/ijazah) : ....................................................................

NIM : .........................................Jenis Kelamin L/P

Prog. Studi/Jurusan : ........................................................................

Tempat/Tgl Lahir : ........................................................................

Lulus Tanggal : ..............................................Lulusan ke........

IPK Kumulatif : .........................Lama Studi............................

Alamat : ........................................................................

.........................................................................

Telepon Rumah : .................................../HP...............................

Judul Skripsi : ........................................................................

.........................................................................

..........................................................................

Semarang,
Pemohon

.........................................
NIM.
KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI
UNIVERSITAS DIPONEGORO
FAKULTAS EKONOMIKA DAN BISNIS
Jl. Prof. H. Soedarto, SH. Tembalang Semarang 50275 Telp. (024) 76486851, 76486853; Fax : (024) 76486852
Jl. Erlangga Tengah No. 17 Semarang 50241 Telp. (024) 8449211, 8446409 Fax. (024) 8449212
Website : Akademik : www.simaweb.fe.undip.ac.id Email : feb@undip.ac.id

FORMULIR PERMOHONAN KARTU ANGGOTA


IKATAN ALUMNI (IKA) UNDIP

Ditulis Dengan Huruf Cetak


Nama (sesuai akte/ijazah) : ........................................................................

NIM : .........................................Jenis Kelamin L/P

Prog. Studi/Jurusan : ........................................................................

Tempat/Tgl Lahir : ........................................................................

Alamat : ........................................................................

.........................................................................

Telepon : .............................HP......................................

Nama Orang Tua : ........................................................................

Pekerjaan Orang Tua : ........................................................................

Semarang,

Pemohon,

...........................................
NIM.

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