FTUB Student Application Form:

  1. Active Study Certificate (for PNS)
  2. Active Study Certificate (for the other purposes)
  3. Active Study Certificate (EN)
  4. Dispensation Letter
  5. Scholarship Application Letter


  1. Download the required forms
  2. For form 1-5, after filling the form, please send the file (word) back to:
    Mr Suradi WhatsApp: +62 812-3525-4600
  3. For form 6, please sign it first (digitally signed or scanned/pic of the signed form) before resent the soft file to the WA on point 2