Graduation Confirmation Form

NO. Surat : No-10-26-01-2016

Personal Data
OLD DATA NEW DATA Sign

Name : ROBBY WANGSA SAPUTRA Name : ROBBY WANGSA SAPUTRA .....

Place of Birth : JAKARTA Place of Birth : JAKARTA .....

Date of Birth : 11/06/1994 Date of Birth : 11/06/1994 .....

Home Address : JALAN PORIS GARDEN BLOK A 1 / 11 A Home Address : JALAN PORIS GARDEN BLOK A 1 / 11 A

Temporary Address : JALAN PORIS GARDEN BLOK A 1 / 11 A Temporary Address : ..........................................................................

Postal Code : 14430 Postal Code : 14430

Home Phone : .......................................................................... Home Phone : 02155703800

Company Name : .......................................................................... Company Name : ..........................................................................

Office Address : .......................................................................... Office Address : ..........................................................................

Mobile Phone : 087883199699 Mobile Phone : 087883199699

Division : .......................................................................... Division : ..........................................................................

Email Address : robby_ws@[Link] Email Address : robby_ws@[Link]

Thesis Data
Title of Thesis in Bahasa : PENGARUH SUPPLY CHAIN MANAGEMENT Title of Thesis in Bahasa : PENGARUH SUPPLY CHAIN MANAGEMENT
TERHADAP KINERJA PT. KAIROS TANGGUH TERHADAP KINERJA PT KAIROS TANGGUH
PERSADA JAKARTA BARAT PERSADA JAKARTA BARAT

Title of Thesis in English : THE INFLUENCE OF SUPPLY CHAIN Title of Thesis in English : THE INFLUENCE OF SUPPLY CHAIN
MANAGEMENT TOWARD COMPANY MANAGEMENT TOWARD COMPANY
PERFORMANCE ON PT. KAIROS TANGGUH PERFORMANCE ON PT KAIROS TANGGUH
PERSADA PERSADA

Major : International Bus. Management Major : International Bus. Management

Degree : S1 Degree : S1

Internship Data
Internship Work Place :- Internship Work Place : ..........................................................................

Period :-/- Period :-/-

Staff Student

(........................................................) (........................................................)

Lampiran yang harus disertakan:

Untuk perubahan Nama: Untuk perubahan Tempat Lahir dan Tanggal Lahir:
a. Surat Permohonan Perubahan Nama (Download template) a. Akte Lahir (fotokopi)
b. Surat Pernyataan Perubahan Nama (Download template)
c. Akte Lahir (fotokopi) Untuk perubahan Judul Skripsi:
d. Surat Keterangan Perubahan Nama dari Catatan Sipil (fotokopi jika ada) a. Form Penggantian Judul (Download formulir)
e. Kartu Keluarga/Ijazah terakhir (fotokopi jika dibutuhkan)

Untuk perubahan data kerja praktek, staff harus memeriksa berkas laporan kerja praktek

I declare the information I have submitted to be TRUE, and I will accept the consequences according to the University of Conduct if the information is found to be incorrect.
I will not ask Bina Nusantara University to re-print my graduation files for any incorrect information that I have given.
Jika terjadi kesalahan sehubungan informasi yang saya berikan diatas, saya tidak akan meminta pihak Universitas Bina Nusantara untuk mencetak ulang berkas kelulusan saya kembali.