Laporan Periodik PKL Dan TA

FRM/DPD/PKL/010
KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN

INSTITUT PERTANIAN BOGOR
SEKOLAH VOKASI
Kampus IPB Cilibende, Jl. Kumbang No.14 Bogor 16151
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
LAPORAN PERIODIK
PRAKTIK KERJA LAPANGAN DAN TUGAS AKHIR
Periode Laporan : ……………………………..……………………………..
………
Nama Mahasiswa / NIM : ……………………………..…………………………….. FRM/DPD/PKL/011
……… DEPARTEMEN PENDIDIKAN NASIONAL
Program Keahlian : INSTITUT
EkowisataPERTANIAN BOGOR
Nama Instansi DIREKTORAT PROGRAM DIPLOMA
: ……………………………………………………………………
Alamat Kampus :IPB Cilibende, Jl. Kumbang No.14 Bogor 16151
……………………………………………………………………
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
No. Revisi : 01 Hal: 1/1 Tanggal Berlaku : 1 Februari 2010
PEMILIHAN MINAT BIDANG KAJIAN PKL*)
PROGRAM KEAHLIAN …………………………………..
TAHUN AKADEMIK 20.../20...
Nama : ............................................................
NIM : ........................
Usulan Minat Bidang Kajian**) :

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

Nama Perusahaan/Instansi : ...............................................................................
...............................................................................
Alamat Lengkap : ...............................................................................

...............................................................................
...............................................................................
Nama Pimpinan Perusahaan/Instansi : ...............................................................................
Contact Person/Telepon/HP/E-mail : ...............................................................................

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)
Keterangan
*) Dikumpulkan paling lambat Tgl ...................
**) Urutan berdasarkan prioritas FRM/DPD/PKL/010
SEKOLAH VOKASI
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Periode Kegiatan : Minggu ......... (...................................................... 2020)
Tanggal Informasi yang diperoleh Masalah/Kendala
FRM/DPD/PKL/011
DEPARTEMEN PENDIDIKAN NASIONAL
DIREKTORAT PROGRAM DIPLOMA
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Nama : ............................................................
NIM : ........................

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

...............................................................................
Alamat Lengkap : ...............................................................................

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

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)
Keterangan
SEKOLAH VOKASI
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
PKL
FRM/DPD/PKL/011
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Nama : ............................................................
NIM : ........................

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

...............................................................................
Alamat Lengkap : ...............................................................................

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

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)
Keterangan
SEKOLAH VOKASI
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
TA
FRM/DPD/PKL/011
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Nama : ............................................................
NIM : ........................

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

...............................................................................
Alamat Lengkap : ...............................................................................

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

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)
Keterangan
SEKOLAH VOKASI
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Catatan Khusus
......................................................................................................................................... ..............
......................................................................................................................................... ..............
______________, _____________________
Mengetahui,
Pembimbing Lapang
FRM/DPD/PKL/011
________________________________
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Nama : ............................................................
NIM : ........................

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

...............................................................................
Alamat Lengkap : ...............................................................................

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

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)
Keterangan
SEKOLAH VOKASI
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
(Nama Jelas, Tanda tangan dan Stempel)
FRM/DPD/PKL/011
Telp. (0251) 8329101, 8329051, Fax (0251) 8329101
Nama : ............................................................
NIM : ........................

1. .......................................................
2. .......................................................
3. .......................................................
Usulan Lokasi PKL :

...............................................................................
Alamat Lengkap : ...............................................................................

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

...............................................................................
...............................................................................
Bogor, ____________________
Mahasiswa,
(__________________________)

Laporan Periodik PKL Dan TA

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Laporan Periodik PKL Dan TA

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FRM/DPD/PKL/010

KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

Periode Kegiatan : Minggu ......... (...................................................... 2020)

Tanggal Informasi yang diperoleh Masalah/Kendala

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

Usulan Minat Bidang Kajian**) :

Usulan Lokasi PKL :

Alamat Lengkap : ...............................................................................

Contact Person/Telepon/HP/E-mail : ...............................................................................

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