FM-BINUS-AA-FPU-753/R0

Formulir Penambahan Mata Kuliah

Additional Subject Form
Semester: Ganjil/ Genap (*) Tahun Akademik/ Academic Year:.....................Periode: 1 / 2 (*)

Admit Term:….Masa Studi:….. Aktif Terakhir:…… SKS:….. IPK:….

NIM/ Student ID :
Tanggal/ Date :
Program Studi/ Study Program :
Nama/ Name :

PENTING!!!
 Formulir ini hanya berlaku untuk matakuliah yang dibuka pada periode tersebut.
 Matakuliah yang diulang adalah grade D/E dan matakuliah MPM (Matakuliah Pengawasan Mutu).
 Jumlah matakuliah yang Anda tambah tidak boleh melebihi maksimal matakuliah yang diikuti per periode (3 matakuliah).
 Pengisian yang tidak lengkap/ tidak jelas tidak akan diproses !!!

Diisi oleh mahasiswa

Detail is filled by Student
KD MTK Nama Mata Kuliah Nilai Minimum Nilai SKS
UPM
Course Code Course Name Minimum Grade Grade Credit

Total
Diisi oleh Staf Nilai
Detail is filled by Grading Staff
KD MTK Nama Mata Kuliah Nilai Minimum Nilai SKS
UPM
Course Code Course Name Minimum Grade Grade Credit

Total
(*) Coret yang tidak perlu

Signature by:

Student Student Service Staff Grading Staff Checked by

 FM-BINUS-AA-FPU-753/R0
Rincian pembayaran diisi oleh Staf Administrasi Keuangan
Payment detail is filled by Financial Administration Staff
Jenis Rincian Biaya Cara Pembayaran Paraf
Item Cost Breakdown Payment Method Staf Administrasi
Keuangan
Signature by Finance Adm.Staff

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Diperiksa oleh*
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*Min. Binusian Grade 10 dari unit yg berwenang/ Min. Binusian Grade 10 from the authorized unit

Diisi oleh Staf Penjadwalan

Filled by Scheduling staff
Catatan: Paraf
Note Staf Penjadwalan
Signature by Scheduling Staff

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Diperiksa oleh*
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*Min. Binusian Grade 10 dari unit yg berwenang/ Min. Binusian Grade 10 from the authorized unit

Diisi oleh Staf Layanan Mahasiswa

Filled by Student Service Staff
Catatan (Informasi ke Mahasiswa) (Telp/ e-mail)* Signature by Student Service
Note (Information to student) (Telp/ e-mail) Staff

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