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TC 1708/08, NH Bypass Road, Behind South Indian


Bank, Chakai Junction PO, Pettah
Thiruvananthapuram

Project / Internship Application Form

1. Name : uzair ahmad

2. Qualification: Btech + MTech biotechnology

3. College Name: Amity university

4. Local Address: E 11 /84 malviya nagar new delhi

5. Permanent Address: E 11 /84 malviya nagar new delhi

6. Phone No. : 9911499795

7. E – mail Address: zairahmadd@gmail.com

8. Internship / Project title :

9. Internship start date :

10. Internship End Date:

11. Area of work:

12. Payment Details: Gpay

I approve to the internship plan stated by the company.

Uzair ahmad
Students Signature

For Office Use Only

Director
Date:31/12/202
2

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