Blangko Isian SKPI 0

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI
UNIVERSITAS JENDERAL SOEDIRMAN

FAKULTAS PERIKANAN DAN ILMU KELAUTAN
Jl. Dr. Suparno Komp. GOR Susilo Sudarman Karangwangkal Purwokerto
Telp. & Fax : (0281) 642360 Website : fpik.unsoed.ac.id
Email : fpik.unsoed@gmail.com
Daftar Isian Mahasiswa untuk keperluan SKPI (Surat Keterangan Pendamping Ijazah)
1. NIM

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2. NAMA MHS

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3. TEMPAT/TGL LAHIR

: ......................................................................................

4. TAHUN MASUK

:......................................................................................

5. PRODI

: ......................................................................................

6. PENGHARGAAN DAN PEMENANG KEJUARAAN (PRESTASI) :
Nama Kejuaraan /Prestasi / Penghargaan
No
(dalam Bhs Indonesia dan Bhs Inggris)

7. SEMINAR NASIONAL/INTERNASIONAL
Seminar Nasional/Internasional
No
(dalam Bhs Indonesia dan Bhs Inggris)

8. PENGALAMAN ORGANISASI
No

Nama Organisasi
(dalam Bhs Indonesia dan Bhs Inggris)

9. JUDUL TUGAS AKHIR ( BHS INDONESIA DAN BHS INGGRIS)
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10. BAHASA INTERNASIONAL ( MISAL TOEFL)
No

Keterangan

11. JUDUL MAGANG ( BHS IND & BHS INGGRIS)
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12. Soft Skill Training / Pendidikan Karakter ( BHS IND & BHS INGGRIS)
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