Technical Internship Program

2014

Annexure I

Mukesh Patel School of Technology Management

& Engineering
Technical Internship Program
Initial Information Report (IIR)
Name of the Student

Roll No.

Contact Details

: Mobile _______________ Email______________

Name of the Organization

Address of the Organization

.
City: . Pin: .
Main Activity of the Organization

Name of the Head of the Organization

Name of the HR

Designation and Address of the HR

:.
City: Pin:

Telephone Numbers

: (O) .. (M) ..

E-mail

Name &Designation of the Project Guide

.
.
..
Telephone Numbers

: (O) .. (M) ..

Email

Reporting Date & End date

Internship Period

: From To.

Technical Internship Program 2014

Facilities Available to the Students

Work Timings at the Organization

Amount of Stipend Expected to be

Provided ( If Any)

Description of Project in brief

....
....
....
....
: ..

TIP Schedule at the Organization

....

Date:

Signature & Name of the Student

..
Signature of Project Guide (Mentor)

Name of Faculty(Supervisor) assigned

To guide the Student

.
Signature of HOD

Signature of Dean

Date:

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