Form A4 Penilaian PKL (MD)

KEMENTERIAN AGAMA REPUBLIK INDONESIA
UNIVERSITAS ISLAM NEGERI

SULTAN AJI MUHAMMAD IDRIS ( UINSI ) SAMARINDA
FAKULTAS USHULUDDIN, ADAB DAN DAKWAH
Kampus I : Jl. KH Abul Hasan No. 03, Telp. (0541) 742193, Fax. (0541) 7268933 Samarinda
Website : http://www.fuad.uinsi-samarinda.ac.id E-mail : fuad@uinsi-samarinda.ac.id
LEMBAR PENILAIAN PRAKTEK KERJA LAPANGAN (PKL) MAHASISWA

FORM A4
PROGRAM STUDI MANAJEMEN DAKWAH (MD)
A. DATA INSTANSI
Nama Perusahaan/ Lembaga : .........................................................................
Alamat : ..........................................................................
Telepon/Fax. : ..........................................................................
B. DATA MAHASISWA
Nama Mahasiswa : ..........................................................................

Nomor Induk Mahasiswa : ..........................................................................
Telepon : ..........................................................................
Tanggal PKL : ........................... s/d ..................................
C. PENILAIAN
NILAI ANKA
NO. ASPEK PENILAIAN (0 - 100)
1 Etika dan kepribadian/akhlaq
2 Kedisiplinan (kehadiran, kerapihan berpakaian, kebersihan tempat kerja, dll.)
3 Kepemimpinan
4 Kemampuan menguasai materi pekerjaan
5 Kerajinan, ketelitian, ketekunan, kreativitas, tanggung jawab
6 Kemampuan melakukan inisiatif dalam pekerjaan
7 Kemampuan bekerjasama dalam tim (team working)
8 Kemampuan berkomunikasi
Kemampuan menggunakan teknologi informasi dan komunikasi sebagai alat
9 bantu pekerjaan (komputer, laptop, internet, LCD., dll.)
10 Laporan PKL (diisi oleh supervisor)
NILAI RATA-RATA (diisi oleh supervisor)
Samarinda, ........................................
Supervisor, Pembimbing Lapangan,
……………………………………………..
……………………………………………...
NIP. NIP.
D. Saran terhadap MAHASISWA yang melaksanakan PKL

(diisi oleh pihak Instansi/Lembaga)
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E. Saran terhadap PROGRAM STUDI untuk perbaikan

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Keterangan:
1. Konversi nilai
Rentang Nilai Huruf

86 - 100 A
70 - 85 B
60 - 69 C
50 - 59 D
00 - 50 E
2. Form penilaian ini diserahkan oleh instansi/pembimbing lapangan kepada mahasiswa yang
melaksanakan PKL dalam amplop tertutup untuk diserahkan kepada supervisor/program
studi.
FORM A4
PROGRAM STUDI KOMUNIKASI DAN PENYIARAN ISLAM (KPI)
A. DATA INSTANSI
Alamat : ..........................................................................
Telepon/Fax. : ..........................................................................
B. DATA MAHASISWA
Nama Mahasiswa : ..........................................................................

Telepon : ..........................................................................
Tanggal PKL : ........................... s/d ..................................
C. PENILAIAN
NILAI ANKA
3 Kepemimpinan
Samarinda, ........................................
…………………………………………… .
…………………………………………...
NIP. NIP.

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Keterangan:
1. Konversi nilai
Rentang Nilai Huruf

86 - 100 A
70 - 85 B
60 - 69 C
50 - 59 D
00 - 50 E
studi.
FORM A4
PROGRAM STUDI MANAJEMEN DAKWAH (MD)
A. DATA INSTANSI
Alamat : ..........................................................................
Telepon/Fax. : ..........................................................................
B. DATA MAHASISWA
Nama Mahasiswa : ..........................................................................

Telepon : ..........................................................................
Tanggal PKL : ........................... s/d ..................................
C. PENILAIAN
NILAI ANKA
3 Kepemimpinan
Samarinda, ........................................
…………………………………………. ………………………………………….
NIP. NIP.

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Keterangan:
1. Konversi nilai
Rentang Nilai Huruf

86 - 100 A
70 - 85 B
60 - 69 C
50 - 59 D
00 - 50 E
studi.
FORM A4
PROGRAM STUDI ILMU ALQUR’AN & TAFSIR (IAT)
A. DATA INSTANSI
Alamat : ..........................................................................
Telepon/Fax. : ..........................................................................
B. DATA MAHASISWA
Nama Mahasiswa : ..........................................................................

Telepon : ..........................................................................
Tanggal PKL : ........................... s/d ..................................
C. PENILAIAN
NILAI ANKA
NO. ASPEK (0 - 100)
1 Etika dan kepribadian/akhlaq PENILAIAN

3 Kepemimpinan
Samarinda, ........................................
…………………………………………….. ……………………………………………..
NIP. NIP.

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Keterangan:
1. Konversi nilai
Rentang Nilai Huruf

86 - 100 A
70 - 85 B
60 - 69 C
50 - 59 D
00 - 50 E
studi.

Form A4 Penilaian PKL (MD)

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Form A4 Penilaian PKL (MD)

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KEMENTERIAN AGAMA REPUBLIK INDONESIA

UNIVERSITAS ISLAM NEGERI

LEMBAR PENILAIAN PRAKTEK KERJA LAPANGAN (PKL) MAHASISWA

Nama Mahasiswa : ..........................................................................

Supervisor, Pembimbing Lapangan,

D. Saran terhadap MAHASISWA yang melaksanakan PKL

E. Saran terhadap PROGRAM STUDI untuk perbaikan

Rentang Nilai Huruf

Nama Mahasiswa : ..........................................................................

Supervisor, Pembimbing Lapangan,

D. Saran terhadap MAHASISWA yang melaksanakan PKL

E. Saran terhadap PROGRAM STUDI untuk perbaikan

Rentang Nilai Huruf

Nama Mahasiswa : ..........................................................................

Supervisor, Pembimbing Lapangan,

D. Saran terhadap MAHASISWA yang melaksanakan PKL

E. Saran terhadap PROGRAM STUDI untuk perbaikan

Rentang Nilai Huruf

Nama Mahasiswa : ..........................................................................

2 Kedisiplinan (kehadiran, kerapihan berpakaian, kebersihan tempat kerja, dll.)

Supervisor, Pembimbing Lapangan,

D. Saran terhadap MAHASISWA yang melaksanakan PKL

E. Saran terhadap PROGRAM STUDI untuk perbaikan

Rentang Nilai Huruf

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