NAMA PEMBIMBING : …………………………………………… 12. Surat tugas dibuat rangkap 2, diserahkan ke Sekretaris Kompetensi Keahlian untuk dibuat
rekapnya (format bisa minta di POKJA PRAKERIN), rangkap 1 diserahkan ke POKJA
NIP : ……………………………………………
PRAKERIN beserta rekap maksimal 2 minggu dari masing-masing pelaksanaan kegiatan,
PELAKSANAAN PRAKERIN : 10 Pebruari 2017 s.d 10 Mei 2017
rangkap 2 diarsip Sekretaris Kompetensi Keahlian. Berlaku pula untuk Berita Acara Serah
KELAS : XI PS/RPL/MM/TKJ Terima (kecuali apabila pihak DuDi minta 1 rangkap, maka POKJA PRAKERIN cukup di
KOMPETENSI KEAHLIAN : ……………………………………………. copykan saja, sedangkan yang asli diarsip Sekretaris Kompetensi Keahlian).
13. Masing – masing peserta didik wajib membuat laporan kegiatan PRAKERIN. Laporan yang
diserahkan ke POKJA PRAKERIN cukup 5 laporan terbaik dari masing-masing Kompetensi
Keahlian, selanjutnya diarsip di Kompetensi Keahlian masing-masing.
14. Buku Monitoring wajib ditandatangani DuDi dan stempel DuDi, dikumpulkan ke POKJA
PRAKERIN maksimal 2 minggu setelah penarikan.
4. Monitoring (ketiga)/CC
Pembimbing DuDi,
NIP.
TTD PEMBIMBING DU / DI
NO. KEGIATAN HARI/TANGGAL
dan CAP
B. KEGIATAN PEMBIMBINGAN
5. Penarikan Siswa
Pembimbing DuDi,
Pembimbing DuDi,
NIP.
4. Monitoring (ketiga)/CC
Pembimbing DuDi,
NIP.
1. Penerjunan
B. KEGIATAN PEMBIMBINGAN
2. Monitoring (kesatu)
TTD PEMBIMBING DU / DI
NO. KEGIATAN HARI/TANGGAL
dan CAP 3. Monitoring (kedua)
Pembimbing DuDi,
NIP.
A. TEMPAT PRAKTIK
FO-012 Bukti Monitoring
TEMPAT PRAKTIK DAN Nama Perusahaan / Industri :________________________________________________________
KEGIATAN PEMBIMBINGAN
Alamat Perusahaan / Industri : ________________________________________________________
A. TEMPAT PRAKTIK
No. Telepon : ________________________________________________________
Nama Perusahaan / Industri :________________________________________________________
Periode : 10 Pebruari s.d. 10 Mei 2017
Alamat Perusahaan / Industri : ________________________________________________________
TTD PEMBIMBING DU / DI
Periode : 10 Pebruari s.d. 10 Mei 2017 NO. KEGIATAN HARI/TANGGAL
dan CAP
1. Penerjunan
B. KEGIATAN PEMBIMBINGAN
2. Monitoring (kesatu)
TTD PEMBIMBING DU / DI
NO. KEGIATAN HARI/TANGGAL
dan CAP
3. Monitoring (kedua)
1. Penerjunan
4. Monitoring (ketiga)/CC
2. Monitoring (kesatu)
5. Penarikan Siswa
3. Monitoring (kedua)
4. Monitoring (ketiga)/CC
Pembimbing DuDi,
5. Penarikan Siswa
LAPORAN HASIL PENERJUNAN
NIP.
1. Penerjunan
2. Monitoring (kesatu)
3. Monitoring (kedua)
4. Monitoring (ketiga)/CC
5. Penarikan Siswa
………………………………. ……………………………………
NIP. NIP. NIP.
FO-014 Laporan Hasil Penerjunan
FO-014 Laporan Hasil Penerjunan
LAPORAN HASIL PENERJUNAN
A. Nama Du/Di : …………………………………………………...............................………….
A. Nama Du/Di : …………………………………………………...............................…………. Alamat : ……………………………………………………………................................
Alamat : ……………………………………………………………................................ B. Nama Peserta : ……………………………………………………………................................
B. Nama Peserta : ……………………………………………………………................................ 1. ……………………………………….........................................................................................
1. ………………………………………......................................................................................... 2. . ……………………………………….......................................................................................
2. . ………………………………………....................................................................................... 3. ……………………………………….........................................................................................
3. ………………………………………......................................................................................... 4. ……………………………………….........................................................................................
4. ………………………………………......................................................................................... 5. ……………………………………….........................................................................................
5. ………………………………………......................................................................................... 6. ……………………………………….........................................................................................
6. ………………………………………......................................................................................... 7. ……………………………………….........................................................................................
7. ………………………………………......................................................................................... 8. ……………………………………….........................................................................................
8. ………………………………………......................................................................................... 9. ……………………………………….........................................................................................
9. ………………………………………......................................................................................... 10. ……………………………………….......................................................................................
10. ………………………………………....................................................................................... C. Hasil Diskusi dengan DuDi :
C. Hasil Diskusi dengan DuDi :
………………………………. ……………………………………
………………………………. …………………………………… NIP. NIP.
NIP. NIP. FO-014 Laporan Hasil Penerjunan
FO-014 Laporan Hasil Penerjunan
LAPORAN HASIL PENERJUNAN
LAPORAN HASIL PENERJUNAN
A. Nama Du/Di : …………………………………………………...............................…………. Alamat : ……………………………………………………………................................
Alamat : ……………………………………………………………................................ B. Nama Peserta : ……………………………………………………………................................
B. Nama Peserta : ……………………………………………………………................................ 1. ……………………………………….........................................................................................
1. ………………………………………......................................................................................... 2. . ……………………………………….......................................................................................
2. . ………………………………………....................................................................................... 3. ……………………………………….........................................................................................
3. ………………………………………......................................................................................... 4. ……………………………………….........................................................................................
4. ………………………………………......................................................................................... 5. ……………………………………….........................................................................................
5. ………………………………………......................................................................................... 6. ……………………………………….........................................................................................
6. ………………………………………......................................................................................... 7. ……………………………………….........................................................................................
7. ………………………………………......................................................................................... 8. ……………………………………….........................................................................................
8. ………………………………………......................................................................................... 9. ……………………………………….........................................................................................
9. ………………………………………......................................................................................... 10. ……………………………………….......................................................................................
10. ………………………………………....................................................................................... C. Hasil Diskusi dengan DuDi :
C. Hasil Diskusi dengan DuDi :
………………………………. ……………………………………
NIP. NIP.
………………………………. ……………………………………
FO-014 Laporan Hasil Penerjunan
NIP. NIP.
FO-014 Laporan Hasil Penerjunan
LAPORAN HASIL PENERJUNAN
LAPORAN HASIL PENERJUNAN
A. Nama Du/Di : …………………………………………………...............................………….
A. Nama Du/Di : …………………………………………………...............................…………. Alamat : ……………………………………………………………................................
B. Nama Peserta : ……………………………………………………………................................ 1. ……………………………………….........................................................................................
1. ………………………………………......................................................................................... 2. . ……………………………………….......................................................................................
2. . ………………………………………....................................................................................... 3. ……………………………………….........................................................................................
3. ………………………………………......................................................................................... 4. ……………………………………….........................................................................................
4. ………………………………………......................................................................................... 5. ……………………………………….........................................................................................
5. ………………………………………......................................................................................... 6. ……………………………………….........................................................................................
6. ………………………………………......................................................................................... 7. ……………………………………….........................................................................................
7. ………………………………………......................................................................................... 8. ……………………………………….........................................................................................
8. ………………………………………......................................................................................... 9. ……………………………………….........................................................................................
9. ………………………………………......................................................................................... 10. ……………………………………….......................................................................................
10. ………………………………………....................................................................................... C. Hasil Diskusi dengan DuDi :
C. Hasil Diskusi dengan DuDi :
………………………………. ……………………………………
NIP. NIP.
………………………………. ……………………………………
FO-014 Laporan Hasil Penerjunan
NIP. NIP.
FO-014 Laporan Hasil Penerjunan
LAPORAN HASIL PENERJUNAN
LAPORAN HASIL PENERJUNAN
A. Nama Du/Di : …………………………………………………...............................………….
A. Nama Du/Di : …………………………………………………...............................…………. Alamat : ……………………………………………………………................................
Alamat : ……………………………………………………………................................ B. Nama Peserta : ……………………………………………………………................................
B. Nama Peserta : ……………………………………………………………................................ 1. ……………………………………….........................................................................................
2. . ………………………………………....................................................................................... 2. . ……………………………………….......................................................................................
3. ………………………………………......................................................................................... 3. ……………………………………….........................................................................................
4. ………………………………………......................................................................................... 4. ……………………………………….........................................................................................
5. ………………………………………......................................................................................... 5. ……………………………………….........................................................................................
6. ………………………………………......................................................................................... 6. ……………………………………….........................................................................................
7. ………………………………………......................................................................................... 7. ……………………………………….........................................................................................
8. ………………………………………......................................................................................... 8. ……………………………………….........................................................................................
9. ………………………………………......................................................................................... 9. ……………………………………….........................................................................................
10. ………………………………………....................................................................................... 10. ……………………………………….......................................................................................
C. Hasil Diskusi dengan DuDi : C. Hasil Monitoring / Evaluasi Pelaksanaan :
………………………………. ……………………………………
………………………………. …………………………………… NIP. NIP.
NIP. NIP. FO-014 Laporan Hasil Monitoring
FO-014 Laporan Hasil Monitoring
LAPORAN HASIL MONITORING
LAPORAN HASIL MONITORING KE 1 (satu)
KE 1 (satu)
A. Nama Du/Di : …………………………………………………...............................………….
A. Nama Du/Di : …………………………………………………...............................………….
Alamat : ……………………………………………………………................................
Alamat : ……………………………………………………………................................
B. Nama Peserta :
B. Nama Peserta :
1. ……………………………………….........................................................................................
1. ……………………………………….........................................................................................
2. . ……………………………………….......................................................................................
3. ……………………………………….........................................................................................
4. ………………………………………......................................................................................... 4. ……………………………………….........................................................................................
5. ………………………………………......................................................................................... 5. ……………………………………….........................................................................................
6. ………………………………………......................................................................................... 6. ……………………………………….........................................................................................
7. ………………………………………......................................................................................... 7. ……………………………………….........................................................................................
8. ………………………………………......................................................................................... 8. ……………………………………….........................................................................................
9. ………………………………………......................................................................................... 9. ……………………………………….........................................................................................
10. ………………………………………....................................................................................... 10. ……………………………………….......................................................................................
C. Hasil Monitoring / Evaluasi Pelaksanaan : C. Hasil Evaluasi Pelaksanaan :
10. ………………………………………....................................................................................... 10
C. Hasil Evaluasi Pelaksanaan : 11
12
13
14
15
D. Kritik dan Saran DuDi :
16
17
18
19
20
Mengetahui Semarang, …………….2017
Pembimbing DU/DI Pembimbing Sekolah
KETERANGAN :
………………………………. …………………………………… 1. Tiap hari jumat siswa wajib hadir di sekolah untuk melakukan bimbingan dan pembimbing
NIP. NIP. sekolah wajib melakukan pembimbingan dan absensi siswa.
DAFTAR PRESENSI PEMBIMBINGAN SISWA 2. Apabila Pembimbing berhalangan hadir, mohon dikonfirmasikan ke siswa dan bimbingan dapat
digantikan hari yang lain sesuai kesepakatan dengan siswa.
Paraf 3. Catatan selama pelaksanaan pembimbingan di sekolah dapat dituliskan di lembar CATATAN
Peb Maret April Mei
Pemb PEMBIMBINGAN PRAKERIN.
No Nama Peserta
II III IV I II III IV I II III IV I
4
CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN
NO TANGGAL CATATAN PEMBIMBINGAN PRAKERIN