COMPULSORY INDUSTRIAL TRAINING.

DECLARATION BY STUDENT

(To be submitted to respective HOD’s as per the schedule announced)

Programme: . Institute:

Name of Student: Enrollment No:-

Address:

Contact No. of student:

Contact No. of Parents/Guardian:

 I am a student of fourth / fifth semester, and I am aware that I required to undergo

compulsorily 8 weeks industrial training at fifth/sixth semester as per the schedule given
by the department.

 I am making myself aware of the following aspects of this training.

1. If I don’t complete the Training Satisfactorily, I will not be eligible to attend second
half of the semester if the training is in the first eight weeks.
2. If I am not granted terms in the subjects I am attending during the first 8 weeks of the
semester I will not be eligible to undergo training when held in second half of the
semester.
3. For granting of term of fifth/sixth semester I am required to be granted term in subjects
as well as industrial training.
4. I am required to follow rules and regulations of training organization during training.
5. My training may be terminated by institute and /or industry for misconduct.
6. I cannot hold industry and / or institute responsible for untoward incident that may
take place during training.
7. I will follow all the instructions given to me by institute faculty/ industry.
8. I will make myself aware of evaluation and monitoring scheme of the training.

Sign of student: _____________________ Sign of Parent/Guardian: ______________________

Place: ______________
Date: ___/____/_______
 GOVERNMENT POLYTECHNIC BICHOLIM
MAYEM-BICHOLIM GOA

(PASSPORT SIZE
RECENT
AUTOMOBILE CORPORATION OF GOA LTD
PHOTOGRAPH)

DAILY DIARY
NAME OF TRAINEE:

DIPLOMA COURSE:

ENROLLMENT NO:

TRAINING ORGANIZATION:______________________________________________________

(NAME AND ADDRESS) _____________________________________________________

_____________________________________________________

DURATION OF TRAINING FROM: 12TH AUG TO 12TH OCT

SIGNATURE OF TRAINEE:______________________

_____________________ _______________ ___________________

SUPERVISOR (INDUSTRY) MENTOR HEAD OF DEPARTMENT

Emergency contact Phone no: