2- SURAT PERNYATAAN KESANGGUPAN
SURAT PERNYATAAN KESANGGUPAN
MENGIKUTI SELEKSI CALON PEJABAT ADMINISTRATOR DAN PENGAWAS
(ESELON III DAN IV) DI LINGKUNGAN UNIVERSITAS DIPONEGORO
TAHUN 2017
Yang bertanda tangan di bawah ini , saya :
Nama
:
..............................................................................................
NIP
:
..............................................................................................
Pangkat / Golongan
:
..............................................................................................
Pendidikan Terakhir
:
..............................................................................................
Unit Kerja
:
..............................................................................................
Pengalaman jabatan Strktural / Pengalaman Kerja :
1. ......................................................................................................................................
2. ......................................................................................................................................
3. ......................................................................................................................................
4. ......................................................................................................................................
5. ......................................................................................................................................
6. ......................................................................................................................................
7. ......................................................................................................................................
8. ......................................................................................................................................
Diklatpim / Diklat Teknis yang pernah diikuti :
1. ......................................................................................................................................
2. ......................................................................................................................................
3. ......................................................................................................................................
4. ......................................................................................................................................
5. ......................................................................................................................................
6. ......................................................................................................................................
7. ......................................................................................................................................
8. ......................................................................................................................................
Menyatakan sanggup untuk mengikuti Seleksi Calon Pejabat Administrator / Eselon III dan
Pejabat Pengawas / Eselon IV *) di lingkunganm Universitas Diponegoro.
Apabila menduduki jabatan stuktural Eselon III / IV *), sanggup untuk mengikuti Diklatpim
sesuai peraturan kepegawaian yang berlaku.
Semarang,
Mengetahui Pimpinan Fak. / Unit
.....................................................
Yang menyatakan,
....................................................
NIP.
.................................................
NIP.
*) Coret yang tidak perlu.
MENGIKUTI SELEKSI CALON PEJABAT ADMINISTRATOR DAN PENGAWAS
(ESELON III DAN IV) DI LINGKUNGAN UNIVERSITAS DIPONEGORO
TAHUN 2017
Yang bertanda tangan di bawah ini , saya :
Nama
:
..............................................................................................
NIP
:
..............................................................................................
Pangkat / Golongan
:
..............................................................................................
Pendidikan Terakhir
:
..............................................................................................
Unit Kerja
:
..............................................................................................
Pengalaman jabatan Strktural / Pengalaman Kerja :
1. ......................................................................................................................................
2. ......................................................................................................................................
3. ......................................................................................................................................
4. ......................................................................................................................................
5. ......................................................................................................................................
6. ......................................................................................................................................
7. ......................................................................................................................................
8. ......................................................................................................................................
Diklatpim / Diklat Teknis yang pernah diikuti :
1. ......................................................................................................................................
2. ......................................................................................................................................
3. ......................................................................................................................................
4. ......................................................................................................................................
5. ......................................................................................................................................
6. ......................................................................................................................................
7. ......................................................................................................................................
8. ......................................................................................................................................
Menyatakan sanggup untuk mengikuti Seleksi Calon Pejabat Administrator / Eselon III dan
Pejabat Pengawas / Eselon IV *) di lingkunganm Universitas Diponegoro.
Apabila menduduki jabatan stuktural Eselon III / IV *), sanggup untuk mengikuti Diklatpim
sesuai peraturan kepegawaian yang berlaku.
Semarang,
Mengetahui Pimpinan Fak. / Unit
.....................................................
Yang menyatakan,
....................................................
NIP.
.................................................
NIP.
*) Coret yang tidak perlu.