Biodata Tahun 2012 Calon Dosen/Pegawai Non PNS Yayasan Pendidikan Laniang Makassar

BIODATA (NON PNS)

TAHUN 2012
A. IDENTITAS
1. Nama Lengkap

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

2. NPP/NIK

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

3. Tempat Lahir

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

4. Tanggal Lahir

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

5. Jenis Kelamin

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

6. Agama

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

7. Status Perkawinan

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

8. Pendidikan Tertinggi

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

9. Umur Pada Saat Pelamaran

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

10. Alamat Rumah

Jalan

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

Kode Pos/PO BOX

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

Kota

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

Kab/Kodya

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

Propinsi

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

11. Alamat Kantor

Jalan

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

Kode Pos/PO BOX

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

Kota

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

Kab/Kodya

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

Propinsi

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

12. Telepon

13. Telepon

14. Email

: a. Kantor

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

b. Rumah

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

c. HP

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

: a. Kantor

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

b. Rumah

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

c. HP

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

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

Biodata Tahun 2012 Calon Dosen/Pegawai Non PNS Yayasan Pendidikan Laniang Makassar
B. PENDIDIKAN/KEAHLIAN
1. Jenjang S1/Diploma

Perguruan Tinggi

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

Fakultas

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

Jurusan

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

Program Studi

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

Lulus (Tgl/Bln/Thn)

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

Bidang Keahlian

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

IPK

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

Judul Tugas Akhir

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

2. Jenjang S2/Spesialis I

Perguruan Tinggi

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

Fakultas

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

Jurusan

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

Program Studi

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

Lulus (Tgl/Bln/Thn)

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

Bidang Keahlian

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

IPK

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

Judul Tesis

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

3. Jenjang S3/Spesialis II

Perguruan Tinggi

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

Fakultas

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

Jurusan

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

Program Studi

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

Lulus (Tgl/Bln/Thn)

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

Bidang Keahlian

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

IPK

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

Judul Disertasi

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

Biodata Tahun 2012 Calon Dosen/Pegawai Non PNS Yayasan Pendidikan Laniang Makassar
C. PENGALAMAN MENGAJAR
No.

Mata Kuliah

Semester

SKS

Ganjil

Genap

1.
2.
3.
D. KARYA ILMIAH DAN HASIL PENELITIAN
Daftar Karya Ilmiah dan Hasil Penelitian Utama yang ditulis dalam tiga tahun terakhir :
No.

Judul

Jenis Karya

Diterbitkan Di

Tahun

Jenis Karya

Diterbitkan Di

Tahun

1.
2.
3.
E. PENGALAMAN MEMBIMBING
No.

Judul

1.
2.
3.
F. KARYA ILMIAH DAN HASIL PENELITIAN
Daftar Karya Ilmiah dan Hasil Penelitian Utama yang ditulis dalam tiga tahun terakhir :
No.

Judul

Jenis Karya

Tahun

Status
Keanggotaan

Periode

1.
2.
3.
G. KEANGGOTAAN DALAM ASOSIASI/HIMPUNAN ILMIAH/PROFESI
No.

Nama Asosiasi/Himpunan/Ilmiah

1.
2.
3.
A. KEIKUTSERTAAN DALAM PELATIHAN/KURSUS/SEMINAR/LOKAKARYA
No.

Jenis Pelatihan/Kursus/Seminar/Lokakarya

Status

1.
2.
3.
Makassar,
Nama Calon Dosen,

_____________________

Tahun

Biodata Tahun 2012 Calon Dosen/Pegawai Non PNS Yayasan Pendidikan Laniang Makassar
DAFTAR RIWAYAT HIDUP
Yang bertanda tangan di bawah ini :
N a m a Lengkap

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

Tempat/Tanggal Lahir

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

Alamat

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

Menerangkan dengan sesungguhnya :

1. Riwayat Pendidikan :
a. Sekolah Dasar

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

b. Sekolah Lanjutan Pertama

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

c. Sekolah Lanjutan Atas

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

d. Perguruan Tinggi

Sarjana (S1)

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

Magister (S2)

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

Doktor (S3)

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

2. Riwayat Pekerjaan :
a. Dari tahun . s/d tahun .
......................................................................................................................................
......................................................................................................................................
......................................................................................................................................
b. Dari tahun . s/d tahun .
......................................................................................................................................
......................................................................................................................................
......................................................................................................................................
c. Dari tahun . s/d tahun .
......................................................................................................................................
......................................................................................................................................
......................................................................................................................................
3. Keterangan Lain :
............................................................................................................................................
............................................................................................................................................
............................................................................................................................................
Demikianlah daftar riwayat hidup ini saya buat dengan sebenarnya.
Makassar, .2012
Yang Menyatakan

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