DIRECTORATE OF CAREER AND COMPETENCY OF HUMAN RESOURCES DIRECTORATE GENERAL OF RESOURCES OF SCIENCE, TECHNOLOGY AND
HIGHER EDUCATION
MINISTRY OF RESEARCH, TECHNOLOGY AND HIGHER EDUCATION
FORM SAME-B
A. PERSON IN CHARGE 1. Full name (capital letters)
: ... ...
(Last name)
... (First name)
2. Gender : Male Female
6. Host Institution :
University : ...
(if available)
NIDN : ... ....
Karpeg. ... ...
(if available)
8. Rank (Golongan) : ...
B. INVITEE
1. Name :
2. Institution :
3. Expertise :
Verified by Rector Date : ... Signature of Person in Charge
... ..
NIP. ...
... ...