530 Bush Street, Suite 1000 San Francisco, CA 94108 USA

Tel 415-362-6520

Fax 415-392-4667 www.iie.org Chevron@iie.org

CHEVRON CORPORATION

International REACH Scholarship Program

For Children of Company Employees

ST
1 ACADEMIC PROGRESS REPORT

DEADLINE: December 1, 2016

This is a required report for the information of IIE and your program sponsor.

It is not necessary that exams be completed prior to submission of this report.

Please complete sections A D of this form, and give it your academic advisor who should complete section E and return it to IIE. This
document may be mailed to the above address, emailed as a scanned attachment to chevron@iie.org or faxed to 415-392-4667.

NAME: YUNITA MAHARANI BURHAN

CURRENT MAILING ADDRESS FOR RECEIVING CHECK:

(Please notify IIE if your mailing address changes. NOTE: Post office boxes are not permitted for express mail delivery.)
JALAN SULTAN SYARIF KASIM GANG BADAR NO.03 RT 04 RW 08 KELURAHAN BALAI MAKAM KECAMATAN MANDAU
KABUPATEN BENGKALIS, DURI-RIAU INDONESIA 28784

TELEPHONE NUMBER: +628-13-7853-4479

0765-93968

EMAIL ADDRESS (to be used for most correspondence): yunitamaharani12@gmail.com

SECONDARY (OR PARENTS) EMAIL ADDRESS: bhnudin@chevron.com

ACADEMIC INSTITUTION: UNIVERSITY OF MUHAMMADIYAH JAKARTA

FIELD OF STUDY: MEDICAL STUDENT

DEGREE OR CERTIFICATE YOU ARE SEEKING: BACHELOR OF MEDICAL

ACADEMIC STANDING Year in Schhol (First Year, First Term, etc.): SEPTEMBER, 9 th 2013

ESTIMATED COMPLETION DATE OF YOUR DEGREE OR CERTIFICATE: (If there has been any change in your expected
completion date, please explain.)
Month: __AUGUST______ Year: _2018_____

For this part I want to explain about my study as a medical student. Became as a medical
student is different for the other student who study like a technic etc, because to get a doctor degree
in front of my name (example: dr. Yunita Maharani Burhan) is take a long time, about 3 years from
now. So for this 7th I must make a thesis which I do right now. After a thesis done, I can get a degree
but not in front of my name, just like this Yunita Maharani Burhan, Sked. After that I became a co-
assistant of doctor in the hospital and it takes about 2 years. After I passed that part I must passed
through several step which is following a doctor competency exam of all the people who study as a
medical student in Indonesia. If I pass this step, I can get a doctor degree in front of my name like dr.
Yunita Maharani Burhan as I tell you above. And I became a doctor who dedicate for my country
about one year. And after all I get a lisence a practice as a doctor and I can build my clinic by myself.
So, if get a doctor degree in front my name it takes about 3 years from now, but if only Yunita
Maharani Burhan, Sked i can get it not too much time about 1-2 month ahead. Actually I ever
explain about this.

Thats all about my explanation. Thank you for your attention.

NAME: ___YUNITA MAHARANI BURHAN______

DESCRIPTION OF YOUR STUDY PROGRAM

List all courses for which you are registered this term and plan to register for next term.

PRESENT TERM COURSES NEXT TERM COURSES

ESSAY / THESIS CO-ASSISTANT DOCTOR

Present Term End Date (month/year): _JANUARY__/_2017__ Next Term Start Date (month/year): FEBRUARY_/_2017__

STATUS OF YOUR PROGRAM

Number of Courses/Hours Required for Degree: ___144___

Number Completed: _I am currently in 7th semester____
Number of Terms Required for Degree: ______MIN 7 TERM_
Number Completed: ______________
TRANSCRIPT ATTACHED?
No If no, date transcript will be sent to IIE: ____________

COMMENTS: You are requested to comment on your program, progress or problems below:

SIGNATURE: ____________________________________________ DATE: ___________________

TO BE COMPLETED BY YOUR ACADEMIC ADVISOR

After reviewing the information provided by the student above, please assist us in evaluating the students academic performance so
that we may consider his or her scholarship for renewal.

Is the student making satisfactory progress toward a degree or certificate?

Is the student's academic course load a full-time program of study?

Is the student's estimate of the time needed to complete the program accurate?

Are there any special problems affecting the student's study program?

Please provide any comments that may be useful in evaluating the students academic performance.

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Name of Academic Advisor (please print):________dr. Rayhana, M.Biomed________

TITLE: ________doctor_________________________ DEPARTMENT: _______M.Biomed_________

SIGNATURE: _________________________________________ DATE: _________________

EMAIL ADDRESS: ____rayhanakuddah@yahoo.com_______TELEPHONE NUMBER: __087771344661___________

INSTITUTION WEBSITE (if available):__________fkkumj.ac.id____________________________