1 FORM DOSEN PEMBIMBING SKRIPSI
KEMENTERIAN RISET TEKNOLOGI DAN PENDIDIKAN TINGGI
UNIVERSITAS BRAWIJAYA
FAKULTAS ILMU ADMINISTRASI
Jl. MT. Haryono 163, Malang 65145, Indonesia
Telp. : +62-341-553737, 568914, 558226 Fax : +62-341-558227
http://fia.ub.ac.id
E-mail: [email protected]
PROGRAM STUDI : ............................................
N
O
1.
2.
3.
4.
A. Nama Lengkap
B. Nim
C. Tempat lahir
D. Tanggal Lahir
A.Alamat Malang
B. Alamat Asal
C. No. Telp. / HP
A.......................................................................................
B.......................................................................................
C.......................................................................................
D.......................................................................................
A.......................................................................................
......................................................................................
B.......................................................................................
.......................................................................................
C.......................................................................................
A.Judul Skripsi
B. Dosen Pembimbing Utama
C. Dosen Pembimbing
Pendamping
A......................................................................................
......................................................................................
......................................................................................
......................................................................................
......................................................................................
B.....................................................................................
C.....................................................................................
A. Tanggal Daftar
B. Tgl. Ujian
C. Lulus/Tidak Lulus
D. Predikat
A.....................................................................................
B.....................................................................................
C.....................................................................................
D.....................................................................................
UNIVERSITAS BRAWIJAYA
FAKULTAS ILMU ADMINISTRASI
Jl. MT. Haryono 163, Malang 65145, Indonesia
Telp. : +62-341-553737, 568914, 558226 Fax : +62-341-558227
http://fia.ub.ac.id
E-mail: [email protected]
PROGRAM STUDI : ............................................
N
O
1.
2.
3.
4.
A. Nama Lengkap
B. Nim
C. Tempat lahir
D. Tanggal Lahir
A.Alamat Malang
B. Alamat Asal
C. No. Telp. / HP
A.......................................................................................
B.......................................................................................
C.......................................................................................
D.......................................................................................
A.......................................................................................
......................................................................................
B.......................................................................................
.......................................................................................
C.......................................................................................
A.Judul Skripsi
B. Dosen Pembimbing Utama
C. Dosen Pembimbing
Pendamping
A......................................................................................
......................................................................................
......................................................................................
......................................................................................
......................................................................................
B.....................................................................................
C.....................................................................................
A. Tanggal Daftar
B. Tgl. Ujian
C. Lulus/Tidak Lulus
D. Predikat
A.....................................................................................
B.....................................................................................
C.....................................................................................
D.....................................................................................