Administrative Translation

Administrative Translation

penerjemah : Rico Merika

Disclaimer : penerjemahan ini dibuat hanya untuk tugas kuliah.

POLITEKNIK TONGGAK EQUATOR (POLTEQ) T.A…….. / ……..

Jl. Fatimah No. 1-2, Telp. (0561) 767884 _______/______/____

Pontianak

FORMULIR PENDAFTARAN

A. Data Pribadi Mahasiswa

1. Nama Lengkap : ................................................

2. Tempat / Tanggal Lahir : ................................................

3. Alamat Tinggal Pontianak : ................................................

................................................

4. Alamat Tinggal Daerah Asal : ................................................

5. HP / WA : ................................................

6. Telp. Rumah : ....................................

7. Agama : ....................................

8. Jenis Kelamin : Laki-laki Perempuan

9. Anak ke : ............. dari .......................... bersaudara

B. Riwayat Pendidikan SMA / SMK / Sederajat

Asal Sekolah : ................................................

Kota / Kabupaten : .........................................

Jurusan : .........................................

Tahun Kelulusan : ...................

C. Prestasi Akademik dan Olah Raga

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

D. Program Studi yang Dipilih

English for Business & Professional Communication

Pagi Sore

Budidaya Tanaman Pangan

Teknologi Pangan & Gizi

E. Data Orang Tua / Wali

Nama Lengkap Ayah : ..........................................................................

Ibu : ..........................................................................

Wali : ..........................................................................

Tempat / Tgl Lahir Ayah : ..........................................................................

Ibu : ..........................................................................

Wali : ..........................................................................

Alamat Orang Tua : ..........................................................................

Wali : ..........................................................................

Pekerjaan Ayah / Ibu : .......................................... /.............................

Wali : ..........................................................................

Penghasilan Ayah / Ibu : .......................................... /.............................

Wali : ..........................................................................

HP / Telp. Orang Tua : .......................................... /.............................

Wali : ...........................................................................

Agama Ayah / Ibu : .......................................... /.............................

NB:

- Biaya Formulir, Biaya Pendaftaran dan Biaya Kuliah per semester tidak dapat dikembalikan jika yang bersangkutan mengundurkan diri.

- Biaya pendaftaran dan biaya kuliah per semester yang sudah dibayar dapat dikembalikan jika tidak lulus Ujian Nasional dengan menunjukkan bukti Surat Informasi Kelulusan.

………………….,……………………

(kota) (tanggal)

__________________________

(Nama Lengkap Calon Mahasiswa)

Keterangan

......................................................................................................................................

...................................................................................................................................... ......................................................................................................................................

___ PQ/EX/SV:_____________

Gelombang	Tanggal	Test Masuk
Gelombang Expo	September - Oktober 2022	5 November 2022
	Januari-Februari 2023	9 Februari 2023
		4 Maret 2023
Gelombang I	Maret - Mei 2023	14 April 2023
		3 Juni 2023
Gelombang II	Juni - September 2023	4 Juli 2023
		4 Agustus 2023
		2 September 2023

Biaya formulir: Rp 200.000,-

Syarat-syarat:

- Fotokopi, legalisir:

Ijazah SMA/SMK/sederajat (1 lembar)*

* diserahkan setelah menerima ijazah

- Fotokopi Kartu Keluarga (KK) (2 lembar)

- Pas foto berwarna ukuran 3x4 cm (8 lembar)

(Foto studio dengan latar merah)

- Fotokopi KTP (jika ada - 2 lembar)

- Fotokopi Akta Kelahiran (2 lembar)

Beasiswa Prestasi Akademik

Peringkat Kelas XI	Keringanan Dana Pengembangan
I	100 %
II & III	75 %
IV & V	50 %

Syarat Pengajuan Beasiswa (Terbatas)

- Juara 5 besar saat kelas XI semester 1 dan 2

- Surat keterangan juara kelas dari pihak sekolah

- Fotokopi raport kelas XI sebanyak 1 rangkap (2 semester & dilegalisir)

- Beasiswa hanya diberikan kepada calon mahasiswa yang lulus SMA / SMK / Sederajat pada tahun 2023

- Mendaftar pada Gelombang Expo / Gelombang I

Instructions for your translation:

1. Read the document carefully.

2. Translate the document into English accurately, acceptably, and readably.

3. Use the original document’s layout in your translation.

4. Pay attention to the space you will use in your translation. Do not make the form look weird.

5. The translation decision is yours. I do intentionally not give you detailed instructions in order for me to see your unique translation decision respectively.

6. You may start your translation on the new page (the page after this instruction page).

7. Name your file with this format: Your Full Name_St. Number_Class.

8. Send this document along with your translation to our LMS by your deadline.

Cheers, Mates! 😌

POLITEKNIK TONGGAK EQUATOR (POLTEQ) T.A…….. / ……..

Jl. Fatimah No. 1-2, Telp. (0561) 767884 _______/______/____

Pontianak

FORM REGISTRATION

A. Personal Data of The Student

10. Full Name : ................................................

11. Place / Birth of Date : ................................................

12. Address in Pontianak : ................................................

................................................

13. Hometown : ................................................

14. Mobile / WA Number : ................................................

15. Home Number : ....................................

16. Religion : ....................................

17. Gender : Male Female

18. Child Numbers : ................ of .......................... siblings.

B. High School / Vocational School / Equivalent Education History

Previous School: : ................................................

City / Province : .........................................

Major : .........................................

Year of Graduation: : ...................

C. Academic and Sports Achievements

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

D. Choosen Program Study

English for Business & Professional Communication

Morning Afternoon

Crop Cultivation

Food Technology & Nutrition

E. Parent / Guardian Information

Father’s Full Name : ................................................

Mother’s Full Name : ................................................

Guardian’s Full Name : ................................................

Father’s Place/Date of Birth : ................................................

Mother’s :................................................

Guardian’s : ................................................

Parent’s Address : ................................................

Guardian’s : ................................................

Parent’s Job : .......................................... /...

Guardian’s : ................................................

Parent’s Income : .......................................... /...

Guardian’s : ................................................

Parent’s Number : .......................................... /...

Guardian’s : .................................................

Parent’s Religion : .......................................... /...

NB:

- The Application Form Fee, Registration Fee, and Tuition Fee per semester are non-refundable in case of withdrawal.

- The paid Registration Fee and Tuition Fee per semester can be refunded upon presenting proof of Non-Passing in the National Examination.

………………….,……………………

(City) (Date)

__________________________

(Full Name of Prospective Student)

Explanation

......................................................................................................................................

...................................................................................................................................... ......................................................................................................................................

___ PQ/EX/SV:_____________

Wave	Date	Entrance Test
Expo Wave	September - October 2022	November 5, 2022
	January-February 2023	February 9, 2023
		March 4, 2023
Wave I	March - May 2023	April 14, 2023
		June 3, 2023
Wave II	June – September 2023	July 4, 2023
		August 4, 2023
		September 2, 2023

Application Form Fee: Rp 200.000,-

Requirements:

- Photocopy, legalized:

Senior High School/Vocational Highschool/equivalent diploma (1 sheet)*

* to be submitted upon receiving the diploma

- Photocopy of Family Card (2 copies)

- 8 colored passport-size photos (3x4 cm)

(Studio photo with a red background)

- Photocopy of ID Card (if available -2 copies)

- Photocopy of Birth Certificate (2 copies)

Academic Achievement Scholarship

Class XI Ranking	Tuition Fee Reduction
I	100 %
II & III	75 %
IV & V	50 %

Scholarship Application Requirements (Limited)

- Top 5 in class during semester 1 and 2 of class XI

- Class champion certificate from the school

- 1 copy of class XI report card (2 semesters & legalized)

- Scholarships are only awarded to students who graduate from high school / vocational school / equivalent in 2023

- Apply during the Expo Wave / Wave I

Instructions for your translation:

9. Read the document carefully.

10. Translate the document into English accurately, acceptably, and readably.

11. Use the original document’s layout in your translation.

12. Pay attention to the space you will use in your translation. Do not make the form look weird.

13. The translation decision is yours. I do intentionally not give you detailed instructions in order for me to see your unique translation decision respectively.

14. You may start your translation on the new page (the page after this instruction page).

15. Name your file with this format: Your Full Name_St. Number_Class.

16. Send this document along with your translation to our LMS by your deadline.

Cheers, Mates! 😌

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