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FORMULIR PENGAJUAN SURAT IZIN PENELITIAN / PERMINTAAN DATA

Nama Mahasiswa : ……………………………………..

NIM : ……………………………………

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Judul Penelitian :
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Lokasi Penelitian : ………………………………………………………………………………
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Waktu Penelitian : ………………………….s/d …………………

1………………………………….. Paraf :
Pembimbing :
2……………………………………. Paraf :

Tujuan Penerima Surat : ………………………………………………………………………………


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Ttd Mahasiswa

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Catatan :
- Sudah melalui tahapan SEMINAR PROPOSAL

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