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Lembar Tempelan untuk Sekolah

LEMBAR ALAMAT

KEPADA :

YTH. REKTOR

UNIVERSITAS DIPONEGORO

u.p. PANITIA PSSB

LEMBAGA PENGEMBANGAN DAN PENJAMINAN MUTU PENDIDIKAN (LP2MP)

Gedung ICT Center Lt.1

Kampus Tembalang Semarang (50275)

Telp. (024) 7460033 – 7460041 / Fax. (024) 7460033

PENGIRIM:

NAMA SEKOLAH : ................................................................................................

PROVINSI : ................................................................................................

KABUPATEN/KOTA : ................................................................................................

ALAMAT SURAT : ................................................................................................

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KODE POS : ................................................................................................

JUMLAH PELAMAR : ..................

JURUSAN IPA : ..................

JURUSAN IPS : ..................

JURUSAN BAHASA : ..................

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