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Internship Form

Name

Student Identity Number (NPM)

Mobile Phone Number (WA)

Internship Program

MBKM (Merdeka Learn Independent Campus)

Internship Periods

1 Month

Internship Institution

Example: Ministry of Agrarian and Spatial Planning/National Land Agency (ATR/BPN)

Work Unit

Example: Directorate General of Land and Spatial Survey and Mapping

Placement Location

Example: Bogor Regency Land Office

Name of the Direct Supervisor of the Work Unit/Internship Placement

Supervisor's Phone Number

English