Dr.

MAHALINGAM COLLEGE OF ENGINEERING AND TECHNOLOGY

POLLACHI-642003

INDUSTRIAL VISIT / TOUR APPLICATION FORM

Class Details: Course/Dept. Year/Semester Total strength of the class Date of Visit: No. of Students visiting

Reason for students who are not visiting : Industry Details: Name of the Industry

Contact person @Industry

Contact number @Industry

Industry address for communication: Faculty Details: Accompanying staff

Designation

Contact number

Transport Details: Mode of Transport

By Bus / Train

Name of the Travel and Address

Check List: S.No. 1. 2. 3. 4. 5. 6.

7. 8.

Documents

Dept. IIPC Coordinator Verification & Signature

Remarks & Signature of IIPC Coordinator

Industry Permission Letter Students Name List Signed Class Cancellation Circular Schedule of visit Signed by Accompanying Staff, PC/FA,HOD Hostel Permission form Permit copy or Railway Reservation Details Parents declaration form if it is Industrial Tour
Previous Industrial Visit Report submission

Signature of Class Representatives / IV Co-ordinators with name:

Faculty Advisor

Prog. Co-ordinator

HOD Approved / Not Approved Secretary

Principal

Director

Dr. MAHALINGAM COLLEGE OF ENGINEERING AND TECHNOLOGY

POLLACHI-642003

CLASS CANCELLATION CIRULAR

Course & Department: __________________________________________ Date of class cancellation: __________________________ Purpose _______________________________________________________

Sl.No

Period

Subject

Name of the Staff & Designation

Signature

SCHEDULE OF VISIT
(May be attached separately if it is Industrial Tour)

Starting Place:______________________ Reaching Place:___________________ Approximate Traveling Distance (in KM):_________________

Departure time : Reaching time at company : Lunch time : Departure time from company : Arrival time at college : Amount collected from individual student (including Conveyance/ Boarding): Total amount collected from the students: Accomp. Staff PC Dept. IIPC Coordinator HOD

Dr. MAHALINGAM COLLEGE OF ENGINEERING AND TECHNOLOGY

POLLACHI-642003

HOSTEL PERMISSION FORM

Date:
Course & Department: __________________________________________ Date of permission: __________________________ Purpose _______________________________________________________ Start time: ___________________ Return time: ____________________ Hostel: Sl.No

Boys / Girls
Roll No. Name Signature

Permitted / Not permitted

PC / FA

HOD

HOSTEL WARDEN

Dr. MAHALINGAM COLLEGE OF ENGINEERING AND TECHNOLOGY

POLLACHI-642003

BOARDING & LODGING ARRANGEMENT DETAILS

Course & Department: __________________________________________ Purpose : Industrial Visit/ Tour 1. Visiting Place: Bangalore / Mysore / Hyderabad/ Chennai / Hosur/Other (if mention) Name of the Travels, Address & Name of the Hotel, Address & No. of days for Sl.No Contact person Contact person staying

Amount collected from individual student for the particular place (including Boarding/ Lodging/ Conveyance): Total amount collected from the students:
2. Visiting Place: Bangalore / Mysore / Hyderabad/ Chennai / Hosur/ Other (if mention) Name of the Travels, Address & Name of the Hotel, Address & No. of days for Sl.No Contact person Contact person staying

Amount collected from individual student for the particular place (including Boarding/ Lodging/ Conveyance): Total amount collected from the students:

Dept. IIPC Coordinator

PC

HOD

Dr. MAHALINGAM COLLEGE OF ENGINEERING AND TECHNOLOGY

POLLACHI-642003 INDUSTRY INSTITUTE PARTNERSHIP CELL

INDUSTRIAL VISIT / TOUR REPORT

Date:

Course & Department Date(s) of Visit No. of Students visited Accompanying Staff Members Name & Address of the Company

Feedback & Authorized Signatory from the Company

Technical details about the Company Comments

Enclosed / Not enclosed

Accomp. Staff

Dept. IIPC Coordinator

PC

HOD