Application Format for Internship Programme

To
The Member Secretary,
MP State Legal Services Authority,
Jabalpur

Sub. – Regarding Permission for Internship Programme.

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Sl.No. Particulars Information

01 Name
02 Father’s Name
03 Date of Birth
04 Mob. No.
05 Email Id
06 Current Address
07 Permanent Address
08 Currently studying in
09 College/University Name
10 Specific Name of the Legal Services
institution from which internship required.
(MPSLSA/DLSA)
11 Duration of Internship with specific date
12 Any other information
Note :- Please attach Recommendation letter of concern institution regarding
Internship & any ID proof of Applicant such as Aadhar Card/Voter ID
card/College ID / any Other ID proof. Attach any other related document if
necessary.

Date :- Name & Signature

Place :- of Applicant