Kesepakatan :
- Mata kuliah dihapus : .................... mata kuliah (....... sks)
- sks diakui : .................... sks
- sks kurang : .................... sks
- sks sisa : .................... sks
Waingapu, ....................................
..................................................................... .................................................................
Dosen Wali Studi Pemohon
Tembusan :
Ketua Program Studi ..................