7/25/2019 Permohonan Surat Masih Studi
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PERMOHONAN SURAT PERNYATAAN MASIH AKTIF STUDI
Tanggal:
KepadaYth. Dekan FST USDc.q. ag. Ke!aha"#"$a Sek%et. FST
Dengan h&%!at'
Sa(a (ang )e%tanda tangan d# )a$ah #n#'
Na!a * N I M :
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* ...........................
Se!e"te%*Th.Akade!#k
:............................................ *
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Data O%ang T+a ")):
Na!a O%ang T+a
:.......................................................................................
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NIP*NRP ,ARI-
:.......................................................................................
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Pangkat*&l&ngan*R+ang :
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In"tan"# Ke%/a
:.......................................................................................
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Ala!at R+!ah :
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Menga/+kan pe%!&h&nan +nt+k d#)+atkan S+%at Kete%angan
Ma"#h Akt#0St+d# g+na !elengkap# data d# pe%+"ahaan te!pat
&%angt+a ka!# )eke%/a.Data &%angt+a te%"e)+t d# ata" "a(a
#"# dengan )ena% dan apa)#lad#ke!+d#an ha%# ada ke"alahan "a(
)e%"ed#a !ene%#!a "ang"# aka!ed#k!a+p+n ad!#n#"t%a"# "epe%t# (ang
)e%lak+ d# FST * USD
Ata" pe%hat#ann(a "a(a +capkan te%#!a ka"#h.
Pe!&h&n'
