Savitribai Phule Shikshan Prasarak Mandal’s

SKN SINHGAD COLLEGE OF ENGINEERING,

KORTI, PANDHARPUR

STUDENT INTERNSHIP PROGRAM

APPLICATION FORM
Complete and submit to Internship Program Coordinator. (Type or write clearly)
STUDENT INTERNSHIP PROGRAM APPLICATION
FORM
Student Name

Roll No. Program Type Degree

Discipline

Institute Name

Student’s Email ID Student Contact No.

Current Overall GPA Current Semester

Faculty Mentor Name Mentor’s Designation

Faculty Mentor Email Mentor’s Contact No.

ID

Internship Preferences

Industry Sector Location Dream Company/Institution

Preference-1

Preference-2

Preference-3

Faculty Mentor’s Signature: Date: Place:

Signature confirms that the student has attended the internship orientation and has met all paperwork and
process requirements to participate in the internship program and has received approval for Internship from
his/her Advisor.

Student Signature: Date: Place:

Signature confirms that the student agrees to the terms, conditions, and requirements of the Internship
Program.

1
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

REQUEST LETTER FROM INSTITUTE TO INTERNSHIP PROVIDER

Date: / / 20

To,

The General Manager (HR),

------------------------------------

-----------------------------------

------------------------------------

Subject: Request for ---- Weeks Industrial Internship for B. Tech / 4 years Degree
Programme Students.
Dear Sir,
You must be aware that AICTE has made internship mandatory for all technical education
students. In view of the above, I request your good self to allow our following students for
practical training in your esteemed organization.
Kindly accord your permission and give at least one-week time for students to join training
after confirmation.
Sr. Name of Students Roll Year Discipline GPA
No. No.

1.

A line of confirmation will be highly appreciated.

With warm regards,

(Internship Coordinator)

Dept. of___________

SKN Sinhgad College of Engineering

Korti -Pandharpur

Email ID:

Contact No.:
2
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

REQUEST LETTER FROM INSTITUTE TO INTERNSHIP PROVIDER

Date: / / 20
To,
The General Manager (HR),
------------------------------------
-----------------------------------
------------------------------------
Subject: Request for ---- Weeks Industrial Internship for B. Tech / 4 years Degree
Programme Students.
Dear Sir,
Our Students have undergone internship training in your esteemed Organization in the
previous years. I acknowledge the help and the support extended to our students during
training in previous years. We hope this year also our students will get an opportunity to
work with you and understand work culture.
Kindly accord your permission and give at least one-week time for students to join training
after confirmation.
Sr. Name of Students Roll Year Discipline GPA
No. No.

1.
2.
A line of confirmation will be highly appreciated.
With warm regards,

(Internship Coordinator)

Dept. of___________

SKN Sinhgad College of Engineering

Korti -Pandharpur

Email ID:

Contact No.:

3
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

OBJECTIVES/ GUIDELINES/ AGREEMENT:

INTERNSHIP SYNOPSIS (THIS WILL BE PREPARED
IN CONSULTATION WITHFACULTY MENTOR)
This agreement is written by the student in consultation with the faculty Mentor
and Industrial supervisor.

PART I: Contact Information

Student Name

Roll No.

Email ID Contact No.

Institute Name

Faculty Mentor Name

Designation

Email ID Contact No.

Postal Address

Industry Supervisor Name

Designation

Email ID Contact No.

Industry Sector

Organization Name

Postal Address

4
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

PART II: Internship Objectives/Learning Activities

What do you intend to learn, acquire and clarify through this internship? Try to use concrete, measurable terms
in listing your learning objectives under each of the following categories.
Knowledge Skills
and
Understandi
ng

Learning Activities How will your internship activities enable you to acquire the
knowledge/understanding, and skills you listed above?

Describe how your internship activities will enable you to meet your learning
On the Job Activities objectives. Include projects, research writing, conversations etc. which you will
do while working.

Teaching/Mentorin How your technical knowledge can be applied at the site of the Internship?
g Activities How you can create value through mentoring/help people learn new things.

List reading, writing, contact with faculty supervisor, field trips, observations,
Off the Job etc., you will make and carry out which will help you meet your learning
objectives.

5
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

PART III: Expected Field of Internship (Prepare after consultation with Industry)
Describe in brief the Project Title or the expected topic related to which internship
will be offered

6
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

PART IV: Evaluation

Industry Supervisor will provide following two details to the Faculty Mentor at the end of the Internship

 Total Duration of Internship (In Hours)

 Overall Marks Obtained (Out of 10)

PART V: Agreement
This contract may be terminated or amended by student, faculty coordinator or work supervisor at any time
upon written notice, which is received and agreed to by the other two parties.

Student Name Date Signature

Faculty Mentor Name Date Signature

Industry Supervisor Name Date Signature

7
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

RELIEVING LETTER OF STUDENT FROM INSTITUTE

To,
The General Manager (HR),
------------------------------------
-----------------------------------
------------------------------------
Subject: Relieving letter to below mentioned students of SKN Sinhgad College of Engineering
Korti- Pandharpur.
Dear Sir,
Kindly refer your letter/E-mail dated. --------------------- on the above cited subject. As
permitted by your good self, the following students will undergo Industrial Internship in your
esteemed organization under your guidance & directions.
Sr. Name of Student Roll Branch Faculty Mentor Faculty Email ID Postal Address of
No. No. Name Faculty

This training being an essential part of the curriculum, the following

guidelines have been prescribed in the curriculum for the training. You are therefore,
requested to please issue following guidelines to the concerned manager/Industrial
Supervisor.
1. Internship schedule may be prepared and a copy of the same may be sent to us.
2. Each student is required to prepare Internship diary and report.
3. Kindly check the Internship diary of the student frequently.
4. Issue instruction regarding working hours during training and maintenance
of the attendance record. You are requested to evaluate the student’s performance on the
scale of 1 to 10 where 1 indicates Unsatisfactory and 10 indicates Excellent Performance
and any value in between 1 to 10 holds meaning accordingly.
The performance report of the student (as shown below) must be forwarded to the
Faculty Mentor of the student on completion of training in sealed envelope or to the above-
mentioned email ID of Faculty Mentor. Performance Report should preferably be printed
with Organization Header.

8
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

PERFORMANCE REPORT OF
STUDENT
Name of Student

Total Hours Devoted for Internship

Marks Obtained (Out of 10)

Date Place

Industry Supervisor Name Signature

Your efforts in this regard will positively enhance knowledge and practical skills
of the students, your cooperation will be highly appreciated, and we shall feel obliged.
The students will abide by the rules and regulation of the organization and will
maintain a proper discipline with keen interest during their Internship. The students will
report to you on dated along with a copy of this letter

Yours Sincerely,

(Internship Coordinator)

Dept. of___________

SKN Sinhgad College of Engineering

Korti -Pandharpur

Email ID:

Contact No.:

9
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

STUDENT’S DAILY DIARY/DAILY LOG (Print a copy for per day)

Date Time of arrival Time of Departure

Dept./Division Project Title

Main points of the day (Include Figures, if any)

10
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

EVALUATION OF INTERN BY INDUSTRY SUPERVISOR

EVALUATION PERFORMA
Student Name Roll No.
Institute Name
Internship Project Title
Industry Supervisor Name Organization Name

Internship From (Start Date) Internship To (End Date)

Paramete Marks Obtained (Out of 10)
rs
Behaviors
Performs in a dependable manner
Cooperates with co-workers and supervisors
Shows interest in work
Learns quickly
Shows initiative
Produces high quality work
Accepts responsibility
Accepts criticism
Demonstrates organizational skills
Uses technical knowledge and expertise
Shows good judgment
Demonstrates creativity/originality
Analyzes problems effectively
Is self-reliant
Communicates well
Writes effectively
Has a professional attitude
Gives a professional appearance
Is punctual
Uses time effectively

Overall Marks Obtained (Average of marks entered for above parameters) /10

Industry Supervisor Name Signature

Signature of Industry Supervisor

11
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

PERFORMANCE REPORT OF
STUDENT
Name of Student
Total Hours Devoted for Internship
Marks Obtained (Out of 10) 9 (same as Overall Marks Obtained in section 9.6)
Date Place
Industry Supervisor Name Signature

The performance report of the student must be forwarded to the Faculty Mentor of the student
on completion of training in sealed envelope or to through email to Faculty Mentor.
Performance Report should preferably be printed with Organization Header.

12
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

STUDENT’s FEEDBACK OF INTERNSHIP

(TO BE FILLED BYSTUDENT AFTER INTERNSHIP COMPLETION)
STUDENT FEEDBACK FORM
Student Name Roll
No.
Institute Name
Faculty Mentor Name Faculty’s Designation
Internship Project Title
Industry Supervisor Name Supervisor’s Designation
Organisation Name
Internship From (Start Date) Internship To (End Date)
Give a brief description of Internship
Work

Was your internship experience related Yes, to a Yes, to a slight degree Not related at all
to your major area of study large
degree
This experience has: Strongly Agree Agree No Disagree Strongly
Opinio Disagre
n e
Given me the opportunity to explore
a career field
Allowed me to apply classroom theory to
practice
Helped me develop my decision-
making and problem-solving skills
Expanded my knowledge about the work
world prior to permanent employment
Helped me develop my written and
oral communication skills
Provided a chance to use leadership
skills (influence others, develop ideas
with others, stimulate decision-making
and action)
Expanded my sensitivity to the ethical
implications of the work involved

Made it possible for me to be more

confident in new situations 13
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

Given me a chance to improve my

interpersonal skills
Helped me learn to handle responsibility
and use my time wisely
Helped me discover new aspects of
myself that I didn’t know existed before
Helped me develop new interests and
abilities
Helped me clarify my career goals
Provided me with contacts which may
lead to future employment
Allowed me to acquire information and/
or use equipment not available at my
Institute
In the Institute internship program, faculty members are expected to be mentors for students. Do you feel that your
faculty coordinator served such a function? Why or why not?

How well were you able to accomplish the initial goals, tasks and new skills that were set down in your learning
contract? In what ways were you able to take a new direction or expand beyond your contract? Why were some
goals not accomplished adequately?

In what areas did you most develop and improve?

What has been the most significant accomplishment or satisfying moment of your internship?

What did you dislike about the internship?

Considering your overall experience, how would you rate this internship? (Tick One)
Satisfactory Goo d Excellent
Give suggestions as to how your internship experience could have been improved.

Student Signature Date

14
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

ATTENDANCE SHEET
(Print as per your requirement)
Name of Student
Roll. No
Name of Course
Date of Commencement of Internship
Date of Completion of Training
Organization Name

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Month
& Year

Note:
1. Attendance Sheet should remain affixed in Daily Training Diary. Do not remove or tear
it off.
2. Student should sign/initial in the attendance column. Do not mark ‘P’.
3. Holidays should be marked in Red Ink in attendance column. Absent should be marked
as ‘A’ in Red Ink.
4. Signature of Company Internship supervisor with company stamp/ seal.

Industry Signature:
Industry Supervisor Name:
Email Id:

Attendance Sheet
15
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

Name & Address of Organization

Name of the Student

Roll Number
Name of Course
Date of Commencement of Training
Date of Completion of Training
Month and Year:

Week Monday Tuesday Wednesday Thursday Friday Saturday

1
2
3
4
5
6
7
8
9
10
11
12
 Attendance Sheet should remain affixed in Daily Training Diary. Do not remove or tear it
off.
 Holidays should be marked in Red Ink in attendance column. Absent should be marked
as ‘A’ in Red Ink.
Name and Signature with date of Internship Supervisor-------------------------------------------------

Performa for Evaluation of Internship by Institute

1. Name of Student
16
 Savitribai Phule Shikshan Prasarak Mandal’s
SKN SINHGAD COLLEGE OF ENGINEERING,
KORTI, PANDHARPUR

2. Mob. No.
3. Roll No.
4. Branch/Semester
5. Period of Training
6. Home Address with contact No.
7. Address of Training Site:
8. Address of Training Providing Agency:
9. Name/Designation of Training In- charge
10. Type of Work
11. Date of Evaluation
12. Please rate the following:

Sr.No. Particular Grade

1 Quality and effectiveness of presentation
2 Depth of knowledge and demonstrated skills
3 Variety and relevance of learning experience
4 Practical applications and relationships with concepts taught
5 Internship Report
6 Attendance record, student log, supervisor evaluation

Overall grade:

Additional Remarks:

Signature of Faculty Mentor

17