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    Formulir LKTI 2014

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    68 views1 page

    Formulir LKTI 2014

    Uploaded by

    Muhammad Ariez Rizky
    Formulir LKTI 2014

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PANITIA PELAKSANA LOMBA KARYA TULIS ILMIAH

    HIMPUNAN MAHASISWA BIOLOGI


    FAKULTAS KEGURUAN DAN ILMU PENDIDIKAN
    UNIVERSITAS NUSANTARA PGRI

    Jalan. K.H. Achmad Dahlan 76 Telp : (0354) 771576, 771503, 771495 Kediri

    FORMULIR PENDAFTARAN
    LKTI (Lomba Karya Tulis Ilmiah)
    Tingkat SMA/Sederajat

    1. Judul karya

    2. Asal sekolah

    3. Ketua tim
    a. Nama

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

    b. Tempat dan Tanggal lahir

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

    c. Alamat Rumah

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

    d. No.Telepon/ Handphone

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

    e. Email

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

    4. Anggota 1
    a. Nama

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

    b. Tempat dan Tanggal lahir

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

    c. Alamat Rumah

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

    d. No.Telepon/ Handphone

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

    5. Anggota 2
    a. Nama

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

    b. Tempat dan Tanggal lahir

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

    c. Alamat Rumah

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

    d. No.Telepon/ Handphone

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

    6. Guru pendamping
    a. Nama

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

    b. NIP

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

    c. Tempat dan Tanggal lahir

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

    d. Alamat Rumah

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

    e. No.Telepon/ Handphone

    :.......................................................................
    Nama ketua tim

    (......)

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