You are on page 1of 1

NIIT

___________________________________________________PPPE.FM.07
PP CONVERSION FORM
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.

Name of the Student _______________________________


Registration No. _______________________________
Student_id _______________________________
Name of the Organization where PP is to be converted _______________________________
Full address of the Organization _______________________________
Telephone No: _______________________________
Fax No.: _______________________________
Site Address _______________________________
Telephone/Mobile No.: _______________________________
Names and Designation of the Mentor ______________________________
Telephone/Mobile No. ______________________________
Email _______________________________
Nature of Assignment during PP _______________________________
Monthly Stipend during PP _______________________________
Date of Starting PP _______________________________
Material given to the Student _______________________________

(To be filled in by the Student)


As per the requirements I agree to convert my job with the above Organization as my PP, starting on
______________ (has to be a date after the conversion is approved).
(To be filled in by the IC)
I understand that the organization where PP is being converted is appropriate and they have agreed to:
1.
2.
3.
4.

Abide by the rules of Professional Practice


Abide by period of 1 year of PP without break
To allot a mentor for the student
Issue Acceptance Letter for the Student to commence PP

Students

Signature & Date

CGE
Signature & Date

IC heads
Signature &
Date