APPLICATION FOR CBI INTERNSHIP

NAME(in capital letters)

Address for correspondence
(With contact no.)
E- mail address
Date of Birth
Nationality

Educational Qualification (Starting from Matriculation onward)

S .No. Name of Board Examination Year of Division obtained Subjects

/University/Institution passed Passing with percentage

Course presently pursuing and its duration

Name of the University / Institution (letter from the
present institution Indicating his/her status to be enclosed)
Areas of interest in which internship is required
(indicate 3 options out of the list on page 2)
Why do you want to join this internship in the chosen
area of the interest (not exceeding 300 words )
Recommendations (not exceeding 200 words) from
Professor / Guide / Employer

(Signature of the Candidate)

Undertaking

I UTKARSH GARG son of Shri DEO NATH age______resident of VILL- NARAYANPUR POST- MASKANWA
DIST- GONDA (U.P) 271305 hereby declare that the information given above and in the enclosed documents is true
to the best of my knowledge and belief and nothing has been concealed therein. I am well aware of the fact that if the
information given by me is proved false/not true, I will have to face the punishment as per the law. Also, all the
benefits availed by me shall be summarily withdrawn.

Date: 12/Feb./2020

Place: LUCKNOW

(Signature of the Candidate)