PK.FKK.PPLI.

TAWARAN (1)

INDUSTRIAL TRAINING PLACEMENT FORM

Reference No. :

____________________________

Date

____________________________

SHARMEELA BT MATALI
Industrial Training Coordinator EH220
Faculty of Chemical Engineering
Universiti Teknologi MARA
40450 Shah Alam
Selangor Darul Ehsan
Phone: 013-2990609/03-55436328
Email: fkk.eh220@gmail.com

Fax No. : 03-5543 6300

We hereby AGREE / DISAGREE* to accept your student to undergo the industrial training in our
company within the period of 14th July until 19th September 2014. The particulars of the arrangement
are as follows:
Students name

__________________________________________

Company name

__________________________________________

Company address

__________________________________________
__________________________________________
__________________________________________

Supervisors name

__________________________________________

Department

__________________________________________

Monthly allowance (if any)

__________________________________________

Offer valid until*

__________________________________________

Remarks (if any):

____________________________________________________________________________________
____________________________________________________________________________________
Thank you.
Yours faithfully,

_______________________________
(Signature)
Name : _______________________________________
Position : _____________________________________
Contact No. : __________________________________

*Final date in which the student must send official notification to the above company/organization confirming
placement. In the event that no official notification is sent, the above offer automatically becomes null and void.