A.

Nilai-Nilai Dasar PNS

1.

2.
3.

4.
5.

6.
7.
 LEMBAR PENGENDALIAN MENTOR

NAMA PESERTA ………………………………………………...

NDH ………………………………………………….

JABATAN …………………………………………………

INSTANSI ...........................................................................
Paraf
No Tanggal Kegiatan Output
Mentor
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1.
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2.
……………………. ............................................. ....................................
3.
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4.

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5.

6. ................................ ............................................. ....................................

Kabupaten Teluk Bintuni ...............................2022.

Mentor,

.................................................................
NIP....................................................
 LEMBAR PENGENDALIAN COACH

NAMA PESERTA ……………………………………………………………………….

NDH ……………………………………………………………………….

JABATAN ………………………………………………………………………

INSTANSI ………………………………………………………………………

No Tanggal. Kegiatan Output Via. Telp/SMS/WA

1. …………….. …………….. …………….. ……………..

2. …………….. …………….. ……………..

…………….

3. …………….. …………….. …………….. ……………..

4. …………….. …………….. …………….. ……………..

Manokwari,................................2022.
Coach,

MARIA IMACULATA SAIMAR, S.Pd

NIP. 19680503 199512 2 002
 “JURNAL KEGIATAN HARIAN AKTUALISASI PESERTA LATSAR CPNS”

KABUPATEN TELUK BINTUNI

NAMA PESERTA :.............................................................................................
NDH : ............................................../.............................................
JABATAN : ............................................................................................
INSTANSI : ............................................................................................
HARI KE HARI/TANGGAL JAM KEGIATAN PARAF MENTOR
 ..................................................................................

1. …………………….  ……………………………………………………...
(Dan seterusnya)

 ...................................................................................
 ……………………………………….......................
2. ………………………….
(Dan seterusnya)

Mengetahui,

Mentor,

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