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IMPLEMENTATION ARRANGEMENT FORM

UNIVERSITAS PAMULANG
Judul*:
Nomor *: ………………………………….

Nama Mahasiswa / Dosen : ..........................................................................................................

Prodi / Fakultas :.............................................................................................................

Deskripsi Kerjasama :.............................................................................................................

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

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

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

Tempat Pelaksanaan :.............................................................................................................

PT / Instansi / Perusahaan* :.............................................................................................................

Alamat Pelaksanaan :.............................................................................................................

Negara :.............................................................................................................

Jenis Lembaga :.............................................................................................................

Bentuk Kerjasama :.............................................................................................................

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

Tanggal Awal :.............................................................................................................

Tanggal Akhir :.............................................................................................................

….……………, …………………………..

Penanggung Jawab,

Pimpinan, Kaprodi Manajemen

* Judul : Pendidikan / Penelitian / Pengabdian Kepada Masyarakat


PT : Perguruan Tinggi Dalam Negeri / Perguruan Tinggi Luar Negeri
Instansi : Instansi Pemerintah Dalam Negeri / Luar Negeri
Perusahaan : Industri / Swasta Dalam Negeri / Luar Negeri

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