IDENTITAS MAHASISWA
NAMA:
NIM:
PRODI:
NAMA: ___________________________________________________________
NIM: ___________________________________________________________
PRODI: ___________________________________________________________
DOSEN PEMBIMBING TA: ___________________________________________________
TOPIK: ___________________________________________________________
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YOGYAKARTA, ……………………………………..
BAGIAN AKADEMIK,
Disusun Oleh:
NAMA: _____________________________________________________
NIM: _____________________________________________________
PRODI: _____________________________________________________
PEMBIMBING: ____________________________________________________
(……………………………………)
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Nama mahasiswa
Menyetujui Mengetahui
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Counterpart/supervisor Dosen Pembimbing
Catatan:
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Nama mahasiswa
Menyetujui Mengetahui
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Counterpart/supervisor Dosen Pembimbing
Catatan:
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Nama mahasiswa
Menyetujui Mengetahui
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Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
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Nama mahasiswa
Menyetujui Mengetahui
___________________ _______________________
Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
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Nama mahasiswa
Menyetujui Mengetahui
___________________ _______________________
Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
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Nama mahasiswa
Menyetujui Mengetahui
___________________ _______________________
Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
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Nama mahasiswa
Menyetujui Mengetahui
___________________ _______________________
Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
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Nama mahasiswa
Menyetujui Mengetahui
___________________ _______________________
Counterpart/supervisor Dosen Pembimbing
Catatan:
Laporan secara rinci ditulis/ketik pada kertas A4, untuk dipresentasikan dengan
dosen pembimbing sekaligus penulisan laporan akhir.
Mengetahui,
Mengetahui,
Mengetahui,
Mengetahui,
Mengetahui,
Mengetahui,
NAMA PERUSAHAAN:
Yogyakarta, _________________________
(____________________) (_______________________)
Nama Mhs Counterpart/Supervisor
NAMA PERUSAHAAN:
Yogyakarta, _________________________
(____________________) (_______________________)
Nama Mhs Counterpart/Supervisor
NAMA PERUSAHAAN:
Yogyakarta, _________________________
(____________________) (_______________________)
Nama Mhs Counterpart/Supervisor
NO MHS: _______________________________________________________
PRODI: _______________________________________________________
1 Kedisiplinan 0 - 25
2 Ketrampilan 0 - 25
3 Kerjasama 0 - 25
4 KomunikasI 0 - 25
_________________, _____________________
Counterpart/Supervisor
(__________________________)
Kriteria Penilaian:
1.Kedisiplinan (patuh pada ketentuan, taat pada ToR dan waktu kehadiran)
2.Keterampilan (kreatif dan bertindak secara inovatif)
3.Kerjasama (sanggup menyelesaikan pekerjaan secara tim)
4.Komunikasi (kelancaran berkomunikasi baik dengan counterpart maupun
rekan)
NAMA: _____________________________________________________
PRODI: _____________________________________________________
PEMBIMBING: ____________________________________________________
JUDUL: _____________________________________________________
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TITLE: _____________________________________________________
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Catatan :
Title (judul dalam bahasa inggris) agar benar-benar dikonsultasikan dengan Dosen Pembimbing
Magang, karena akan masuk pada transkrip hasil belajar akhir dan dibaca publik.