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FORMULIR PENGGANTIAN PEMBIMBING PENELAAH 0

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN
FAKULTAS PERIKANAN DAN ILMU KELAUTAN
Jalan dr. Suparno Komp. GOR Susilo Sudarman Karangwangkal Purwokerto
Telp. & Fax. (0281) 642360 & 7607433 Website : fpik.unsoed.ac.id

FORMULIR PENGGANTIAN PEMBIMBING SKRIPSI/KERJA PRAKTEK
Nama

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

NIM

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

Judul Skripsi / KP

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


Pembimbing Utama

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

Pembimbing Anggota

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

Alasan Penggantian :
1) ...........................................................................................................................................
................................................................................................................................................
2) ...........................................................................................................................................
................................................................................................................................................
3) ...........................................................................................................................................
................................................................................................................................................
Usulan pembimbing utama / anggota pengganti (Diisi Ketua Program Studi)
Pembimbing Utama

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


Pembimbing Anggota

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

Mengetahui
Pembimbing yang diganti,

Purwokerto,.............................20.....
Mahasiswa yang bersangkutan,

(.............................................)
NIP : ......................................

(.............................................)
NIM : ......................................
Menyetujui,
Ketua Program Studi,
(...........................................)
NIP : ....................................


FORMULIR PENGGANTIAN PENELAAH SKRIPSI
Nama

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

NIM

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

Judul Skripsi / KP

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

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN
FAKULTAS PERIKANAN DAN ILMU KELAUTAN
Jalan dr. Suparno Komp. GOR Susilo Sudarman Karangwangkal Purwokerto

Telp. & Fax. (0281) 642360 & 7607433 Website : fpik.unsoed.ac.id

......................................................................................................
Penelaah I

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

Penelaah II

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

Alasan Penggantian :
1. ...........................................................................................................................................
................................................................................................................................................
2. ...........................................................................................................................................
................................................................................................................................................
3. ...........................................................................................................................................
................................................................................................................................................
Usulan Penelaah I / II pengganti (Diisi Ketua Program Studi)
Penelaah I


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

Penelaah II

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

Mengetahui
Penelaah yang diganti,

Purwokerto,.............................20.....
Mahasiswa yang bersangkutan,

(.............................................)
NIP : ......................................

(.............................................)
NIM : ......................................
Menyetujui,
Ketua Program Studi,

(...........................................)
NIP : ....................................

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