Nama :___________________________________________________
NIM :___________________________________________________
Progam Studi :___________________________________________________
Judul Penelitian :___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
Pembimbing : ___________________________________________________
Penguji : 1. _________________________________________________
2. _________________________________________________
Hari /Tanggal : ___________________________________________________
Jam : ___________________________________________________
Ruang : ___________________________________________________
(________________) (_________________)
Koordinator Skripsi,
(____________________)