REPLY FORM

INDUSTRIAL TRAINING MEC399 (EM110)

FKMPPLI-EM110-REPLYFORM-02200620
Date: __________________

The Coordinator for Industrial Training,

Diploma EM110 Programme,
Faculty of Mechanical Engineering,
Universiti Teknologi MARA (UiTM), Penang Branch,
Permatang Pauh Campus,
13500 Permatang Pauh, Penang
Email : intern.fkm.uitmpp@gmail.com

Dear Sir/Madam,

This is to confirm that our firm, _____________________________________________________(Company Name) AGREES /

DISAGREES* to accept the student as per information below to undergo internship for _________ weeks** at
out firm starting __________________________ until _____________________________.

Name of Student : _____________________________________________________________

Student ID : _____________________________________________________________
I.C Number : _____________________________________________________________

Thank You.

________________________________

(Signature)

Name of Person-in-Charge : _____________________________________________________________

Designation : _____________________________________________________________
Company Address & Stamp : _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Telephone Number : ________________________ Fax Number : ______________________
Handphone Number :
Email :
Is allowance provided? : YES / NO*
If yes, please state amount or estimated amount in RM: _____________________

* select whichever appropriate

** student must complete a minimum 16 WEEKS as per requirement for Diploma