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PENGAJUAN NARASUMBER UNTUK KULIAH TAMU PRODI MSP/MPK
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Tanggal pengisian form
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MM
/
DD
/
YYYY
Prodi
*
MSP
MPK
Nama pemohon
*
Your answer
Status pemohon
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Dosen
Mahasiswa
No. telepon pemohon
*
Your answer
Nama narasumber yang akan diundang
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Your answer
Asal instansi/lembaga narasumber
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Your answer
Alamat instansi/lembaga narasumber
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Your answer
Tema perkuliahan
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Your answer
Kode/nama matakuliah
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Your answer
Rencana tanggal pelaksanaan kuliah tamu
*
MM
/
DD
/
YYYY
Waktu pelaksanaan (WIB)
*
Your answer
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