SURAT PERMOHONAN

Yth. Wakil Rektor Bidang Umum dan Keuangan

Universitas Negeri Semarang

Dengan hormat saya sampaikan bahwa saya :

Nama : ............................................................................................................
NIM : ...............................................................................................................
Fakultas/Prodi : ....................................................................................................................
Angkatan Tahun : ...................................................................................................................
Jalur Masuk Unnes : .................................................................................................................
Alamat : ..................................................................................................................
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No. Hp : .................................................................................................................
Pekerjaan Ortu : Ayah : ...................................... Ibu : ..............................................
Penghasilan Ortu : Ayah : ...................................... Ibu : …….......................................
Nominal UKT : Rp............................................ Kategori UKT : ……........................
Dengan ini mengajukan Penetapan Ulang UKT dengan alasan :
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Demikian permohonan saya ini dibuat dengan sebenar-benarnya semoga dapat diberikan
kebijaksanaan. Berikut kami lampirkan berkas – berkas pendukung yang diperlukan

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Hormat saya,

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