f.01-ft-ka-01 -...
TRANSCRIPT
KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI
UNIVERSITAS LAMPUNG
FAKULTAS TEKNIK
Jl. Prof. Soemantri Brojonegoro No. 1 Bandar Lampung 35145
Telp. (0721) 704947 Fax (0721) 704947
BLANGKO
SURAT KETERANGAN MASIH KULIAH
Nama : ..............................................................................................................
NPM : ..............................................................................................................
Jurusan/Prodi : ..............................................................................................................
Tahun Akademik/Semester : ..............................................................................................................
Nama Orang Tua : ..............................................................................................................
Pekerjaan : ..............................................................................................................
Instansi/Tempat Kerja : ..............................................................................................................
NIP : ..............................................................................................................
Pangkat/Golongan : ..............................................................................................................
Alamat Rumah : ..............................................................................................................
Bandar Lampung, ................................
Menyetujui: Yang Mengajukan
Ka. Jurusan/Ka. Prodi ............................................
( .......................................... ) ( ....................................... )
NIP ...................................... NPM .................................
Lampirkan:
1. Foto Kopi Slip SPP terakhir
2. Foto Kopi KP4 bagi orang tua yang PNS/ABRI
3. Surat Keterangan dari Perusahaan bagi orang tua yang Pegawai Swasta
F.01-FT-KA-01