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  • SSM Request Form - 1

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    Neeraj Verma
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    This document is an SSM request form for a student to request summer student mentorship (SSM) with a company. It requests the student's name, program details, contact information, proposed SSM dates and location, and recommends approval from various academic departments. Upon approval, a receipt is issued to the student. The form collects essential information for processing the SSM request in 3 sentences.

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    Original Title

    SSM REQUEST FORM_1

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    This document is an SSM request form for a student to request summer student mentorship (SSM) with a company. It requests the student's name, program details, contact information, proposed SSM dates and location, and recommends approval from various academic departments. Upon approval, a receipt is issued to the student. The form collects essential information for processing the SSM request in 3 sentences.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    22 views1 page

    SSM Request Form - 1

    Uploaded by

    Neeraj Verma
    This document is an SSM request form for a student to request summer student mentorship (SSM) with a company. It requests the student's name, program details, contact information, proposed SSM dates and location, and recommends approval from various academic departments. Upon approval, a receipt is issued to the student. The form collects essential information for processing the SSM request in 3 sentences.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    UPES/SSM/2019-20/_____________

    SSM REQUEST FORM


    Name (English as per class 10th Record in Capital Letters):____________________________________________

    ___________________________________________________________________________________________________________________

    Name in Hindi (to be printed on Degree): ________________________________________________________________

    Enrollment No: ___________________________________ SAP ID: __________________________________________________

    Program Name:________________________________ Semester __________________________________________________

    Address:___________________________________________________________________________________________________

    Contact No: ________________________________ Emergency contact No. _____________________________________

    Personal email ID: __________________________________________________________________________________________

    Mid Semester Exam Center (For UG Students only) (Delhi/Mumbai/Bangalore/Dehradun):__________________ ___

    Name of Company/Firm:________________________________________________________________________________________

    Date of Joining: _______________________________ SSM opting from (date) _______________________________________

    Recommended by:
    Department Designation Name Signature Date
    Career Services Head- CS
    SOE Dean
    SCS Dean
    SOD Dean
    SOB Dean
    SOL Dean

    Approval:
    Department Designation Name Signature Date
    Office of Dean (ADI) Dean (ADI)

    Finance: (Only for UG students opting SSM Center outside Dehradun campus)
    Department Designation Name Signature Date
    Finance

    Receipt (To be given to student)

    Received from: Receipt No: UPES/SSM/2019-20/_____________

    Name of student:______________________________________________SAP ID:__________________________________

    Enrollment No: ______________________________________________Programme Name: _____________________________________________________________

    Checked and found correct. (For office use).

    Name of Receiving officer:____________________________________Signature of Receiving officer:_______________________________________________

    Date of Receipt: _____________________________

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