STA05 Buku Standar Penilaian Pembelajaran_121217 STA05 Buku Standar Penilaian Pembelajaran_121217 | Page 63

UNIVERSITAS PELITA HARAPAN
SISTEM PENJAMINAN MUTU INTERNAL
FORM PENGAJUAN TUGAS AKHIR
No. Dok.: FOR01 / PRO0 / STA05 / SPMI-UPH Revisi: 02 Tanggal: 22 Agustus 2016 Halaman: 1 dari 1
1. Nama Mahasiswa
:.......................................................................................................................
2. NPM
:.......................................................................................................................
3. Alamat
:.......................................................................................................................
........................................................................................................................
4. Telepon
:.......................................................................................................................
5. Program Studi
:.......................................................................................................................
6. Semester ke-
:.......................................................................................................................
7. Perolehan sks
:.......................................................................................................................
8. IPK terakhir
:.......................................................................................................................
9. Metodologi Penelitian
:.......................................................................................................................
10 Kerja Praktek
: Lulus / belum lulus(**)
11. Mata Kuliah yang belum lulus:
Nomor
Mata Kuliah
Sks
1 2 3 4 5 6 7 8
Jumlah
Mengetahui, Penasehat Akademik,
Karawaci, ………..…….. Peserta Tugas Akhir
( _______________)( _______________) Nama Jelas
Nama Jelas
(**) Coret yang tidak perlu
True Knowledge, Faith in Christ, Godly Character