FORMULIR PENDAFTARAN

SEMINAR PROPOSAL

Nama : ..........................................................................................................................
NIM : ..........................................................................................................................
Kelompok Bidang Keahlian : ..........................................................................................................................
Semester : ..........................................................................................................................
No. Hp : ..........................................................................................................................
Dosen Pembimbing : ..........................................................................................................................
Judul Proposal : ..........................................................................................................................
..........................................................................................................................
..........................................................................................................................
.
Bersama ini, dilampirkan:
1 Naskah proposal yang telah disetujui dosen pembimbing 3 rangkap
Paraf Tata Usaha,
.
2 Fotokopi Kartu Hadir Seminar
(.................)
.
Checklist diisi oleh Tata Usaha

Mengajukan permohonan untuk Seminar Proposal yang akan dilaksanakan pada :

Diisi oleh Program Studi

Hari/Tanggal : ..............................................................................................................................
Waktu : ..............................................................................................................................
Dosen Penguji : 1) ........................................................................................................................
2) ........................................................................................................................

Palangka Raya, ……………………………..

Mengetahui
Dosen Pembimbing Proposal, Pemohon,

...................................................................... ......................................................................
NIDN. .......................................................... NIDN. ..........................................................

FORMULIR PENDAFTARAN Kode/No. Tanggal Terbit Revisi Halaman

SEMINAR PROPOSAL
F/LP3MPT/FTI/D.07-1.i 12 Februari 2020 0 1 dari 1