uui lembar bebas akademik
Rangkap 1 :
1. DAA
UNIVERSITAS
UBUDIYAH INDONESIA
FORMULIR 1
SURAT KETERANGAN BEBAS AKADEMIK, KEUANGAN DAN KEMAHASISWAAN
SEMINAR PROPOSAL
Nama
Nim
Prodi
Fakultas
Alamat
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
1. Keterangan Bebas Akademik
-
Catatan :
SKS sudah mencukupi (Semua mata kuliah sudah diambil kecuali tugas akhir/skripsi)
Tidak ada Nilai D
…………………………………………………………………………………………………….….
Banda Aceh,
……………………………………………………
Dir. DAA
Ka. Prodi
……………………………………
………………………………………
2. Keterangan Bebas Pinjaman Buku Perpustakaan
Catatan : .......................................................................................................................
................................
.......................................................................................................................
...............................
Banda Aceh,
……………………………………………………
Ka. Perpustakaan,
……………………………………………………
3. Keterangan Lunas Keuangan
Catatan : ...................................................................................................................
....................................
............................................................................................................................
...........................
Banda Aceh,
……………………………………………………
Bag.
Keuangan,
……………………………………………
4. Keterangan Bebas Pinjaman Alat Laboratorium
Catatan : .......................................................................................................................
................................
.............................................................................................................................
..........................
Banda Aceh,
……………………………………………………
Ka. Lab
………….......................,
……………………………………………
5. Keterangan Bebas Kepengurusan UKM/UBM/DLL
Catatan : .......................................................................................................................
..........................
..............................................................................................................................
......................
Banda Aceh,
……………………………………………………
Direktur Kemahasiswaan,
……………………………………………
Catatan : - Persetujuan ditandatangani pejabat yang berwenang dan dibubuhi stempel
DAA2017
-Persetujuan Ka. Lab disesuaikan dengan prodi masing-masing
1. DAA
UNIVERSITAS
UBUDIYAH INDONESIA
FORMULIR 1
SURAT KETERANGAN BEBAS AKADEMIK, KEUANGAN DAN KEMAHASISWAAN
SEMINAR PROPOSAL
Nama
Nim
Prodi
Fakultas
Alamat
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
: …………………………………………………………..
1. Keterangan Bebas Akademik
-
Catatan :
SKS sudah mencukupi (Semua mata kuliah sudah diambil kecuali tugas akhir/skripsi)
Tidak ada Nilai D
…………………………………………………………………………………………………….….
Banda Aceh,
……………………………………………………
Dir. DAA
Ka. Prodi
……………………………………
………………………………………
2. Keterangan Bebas Pinjaman Buku Perpustakaan
Catatan : .......................................................................................................................
................................
.......................................................................................................................
...............................
Banda Aceh,
……………………………………………………
Ka. Perpustakaan,
……………………………………………………
3. Keterangan Lunas Keuangan
Catatan : ...................................................................................................................
....................................
............................................................................................................................
...........................
Banda Aceh,
……………………………………………………
Bag.
Keuangan,
……………………………………………
4. Keterangan Bebas Pinjaman Alat Laboratorium
Catatan : .......................................................................................................................
................................
.............................................................................................................................
..........................
Banda Aceh,
……………………………………………………
Ka. Lab
………….......................,
……………………………………………
5. Keterangan Bebas Kepengurusan UKM/UBM/DLL
Catatan : .......................................................................................................................
..........................
..............................................................................................................................
......................
Banda Aceh,
……………………………………………………
Direktur Kemahasiswaan,
……………………………………………
Catatan : - Persetujuan ditandatangani pejabat yang berwenang dan dibubuhi stempel
DAA2017
-Persetujuan Ka. Lab disesuaikan dengan prodi masing-masing