Contoh Formulir Pengajuan Judul Skripsi ke KOMBI

PROGRAM STUDI PENDIDIKAN BIOLOGI

FAKULTAS KEGURUAN DAN ILMU PENDIDIKAN

UNIVERSITAS JEMBER

Alamat : Jl. Kalimantan III/3 Kampus Tegal Boto PO Box 162 Telp.(0331)330738

FORMULIR PENGAJUAN JUDUL

Nama  / NIM : _________________________________________________/_____________________
SKS / IPK *) : ____________________/________________

Usulan Judul **) :
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________

Persetujuan Komisi Bimbingan ***)
Judul diterima : _______________________________________________________________________________
Dosen Pembimbing : 1.___________________________________________________________ (______________)#)
  2.___________________________________________________________ (______________)#)

Jember, .........................................2012
Mengetahui,
Ketua Komisi Bimbingan





Dr. Jekti Prihatin, M.Si
NIP. 19651009 199103 2 001

Keterangan:
*) dibuktikan dengan transkrip sementara
**) dilampiri matrik penelitian
***) diisi oleh Komisi Bimbingan
#) paraf dosen pembimbing