Nomor : ...........................................

Lampiran : 2 (Dua) Lembar

Perihal : Pengajuan Judul

Kepada Yth.
Dekan Fakultas Syariah
c.q. Ketua Jurusan/Program Studi ...................................................
UIN SMH Banten

Assalamu’alaikum Wr.Wb
Yang bertanda tangan di bawah ini, saya
Nama :...........................................
NIM :...........................................
Semester :...........................................
Fak/Jur/Kls : Fakultas Syariah /.................................. /.........
Dengan ini saya mohon kiranya bapak/ibu menyetujui salah satu judul yang saya
ajukan di bawah ini:
1 ..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
2 ..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
3 ..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
4 ..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
5 ..................................................................................................................................
..................................................................................................................................
..................................................................................................................................
..................................................................................................................................

Demikian, atas perhatian bapak ibu saya sampaikan terimakasih.

Wassalamualaikum Wr. Wb
Serang. ................................ ...20...

Menyetujui. Hormat saya,

Dosen Pembimbing Akademik

............................................................... ........................................................
NIP. NIM.
 KEMENTERIAN AGAMA
UNIVERSITAS ISLAM NEGERI
SULTAN MAULANA HASANUDDIN BANTEN
‫كليــــة الشر يعــــة‬
FAKULTAS SYARIAH
Jl. Jend. Sudirman No. 30 Serang 42118 Telp. 0254-2000323 Fax. 0254-200022 e-mail: uinbanten@yahoo.com

PERTIMBANGAN PENGAJUAN JUDUL

1. NAMA MAHASISWA :...................................................

2. NOMOR INDUK MAHASISWA : ...................................................
3. FAKULTAS/JURUSAN/KELAS : ...................................................
4. PERTIMBANGAN PERTIMBANGAN
A. Pertimbangan Akademik
1) Sampai dengan semester ..............masih punya hutang....................sks
2) Kukerta : Sudah / Belum
3) Praktikum Profesi : Sudah / Belum

B. Bidang Administrasi dan Keuangan

1) Her Registasi SPP T.A ........./.......... dan Lain-lain : Lunas/belum 
2) ...............................................................................................................
3) ...............................................................................................................

Serang, .............................
Kasubbag Akademik,
Kemahasiswaan dan Alumni,

Ina Nurdiana, S.Pd.I.,M.Pd.I.

NIP. 19820731 200912 2 005
5. REKOMENDASI SEKRETARIS JURUSAN
A. Judul layak dibahas sesuai dengan jurusan
B. Judul telah diteliti dari arsip dan belum ada pembahas
C. .................................................................................................................
Serang, .............................
Sekretaris Jurusan,

.................................................
NIP.
6. PERSETUJUAN KETUA JURUSAN
Setuju Untuk dibahas Judul Nomor.................................Dengan Catatan
A. .....................................................................................................................
B. .....................................................................................................................
C. .....................................................................................................................
Serang, .............................
Ketua Jurusan,

………………………………….
NIP.


Coret Yang tidak Sesuai

Melampirkan KHS dari SMT 1 s/d Terakhir



 KEMENTERIAN AGAMA
UNIVERSITAS ISLAM NEGERI
SULTAN MAULANA HASANUDDIN BANTEN
‫كليــــة الشر يعــــة‬
FAKULTAS SYARIAH
Jl. Jend. Sudirman No. 30 Serang 42118 Telp. 0254-2000323 Fax. 0254-200022 e-mail: uinbanten@yahoo.com

Nomor : .....................................................
Lampiran : .....................................................
Perihal : Mohon Persetujuan Pembimbing

Kepada Yth.
Dekan Fakultas Syariah
c.q. Wakil Dekan Bidang Akademik
UIN SMH Banten

Assalamualaikum Wr.Wb

Dengan ini kami ajukan proposal skripsi mahasiswa untuk mendapatkan ketetapan
Sebagai berikut:
1. Nama :...............................................
2. NIM :...............................................
3. Fakultas/Jurusan/Kelas : Syariah /...................../........
4. Judul Skripsi :.....................................................................................
.....................................................................................
.....................................................................................
.....................................................................................
5. Nama Calon Pembimbing Skripsi
1) .............................................................................
2) .............................................................................
3) .............................................................................
4) .............................................................................

Demikian Untuk Maklum Adanya.

Wassalamualaikum Wr. Wb.

Serang, ................................
Ketua Jurusan,

................................................
NIP.

6. Persetujuan Pembimbing, An. Dekan

Serang, .............................
Wakil Dekan Bidang Akademik,

7.
8.

Dr. H. Ahmad Zaini, S.H.,M.Si.

NIP. 19650607 199203 1 005