< HRD Document :: TKAP, Bidadi >

Date: D D M M Y Y Y Y

Project / Internship Request Form

From, To,

HOD Name: General Manager - HR

Toyota Kirloskar Auto Parts Pvt. Ltd.,

Rayan C Mathias Bidadi Industrial Area, Bidadi

Ramanagara District, Pin: 562109

Karnataka, India

Institute address

Profile of the Student Recommended:

Gender [ Mark Ö]
Name Ranjitha Kumara
Male √ Female
Student's Latest
Date Of Birth [as per SSLC / 10th Marks card] 0 7 0 4 1 9 9 5 Photo
[passpost size]
Course M.S.W Branch Sem/Year 4th/2017
Institute should
Mobile Number 7760706473 attest the photo

Landline Number STD code Number

Contact Address Permanent Address: Blood Group B+

s/o Ramesh Suvarna s/o Ramesh Suvarna Identification Mark

Gandhi Nagar Gandhi Nagar

Baikadi Baikadi

Honnala post Honnala post

Udupi Udupi

Pincode 576213 Pincode 576213 Blood Group B+

Physical deformities / limitations (if any)

Emergency Name Relation

Contact Mobile Landline STD code Number

Student Declaration

1. I hereby declare that I shall pursue the assigned P/j work / Internship / Organization Signature
Study / In-Plant Training as per the academic guidelines.

2. I will strictly adhere to all applicable rules, regulations & policies of the company.

Project Guide Declaration

Name Reshma K Designation Assistant Professor

Mail ID k.reshma23@yahoo.com Contact No. 9880384510

I declare that I shall guide the student through the assignment as per
the academic guidelines [attendance, report preparation, presentation Signature
& submission of report.

Head Of Department Declaration

Name Mr.Rayan C Mathias Designation Assistant Professor

Mail ID rayanmathias@gmail.com Contact No. 8971041365

I declare that the said student's character & conduct is satisfactory &
Signature
assure the same during his/her tenure at your company.

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< HRD Document :: TKAP, Bidadi >

IMPORTANT NOTE: for Students & Institution

a. All applicable rules & regulations of the company should be adhered by the student/s.
b. Issue of Permission letter for doing Project/Internship at TKAP is subject to availability of slot & resources.
a. TKAP - HR & assigned Company Guide has all rights to monitor & guide the student/s work & behaviour
during the Project/Internship duration.

If permited for Project/Internship, following are expected from the student before reporting;

1. Project / Internship Request Form [Original copy] with all necessary details, signatures &
attestations.
2. Permission letter from Institute / College on Letter Head, signed by the concerned department HOD
/ Principal.
3. Personal Accident Insurance coverage of self for a sum of Rs.1,00,000/- [Policy period should cover
internship term]. This would be at the cost of the student.
4. The student should make own arrangements for Transportation & Accommodation.
5. The student should wear Formal / Semi-formal outfits with Industrial Safety Shoes.
6. The student’s one latest stamp size colour photo.
7. One student can be permitted only once for TKAP [Either Project or Internship].

On completion of Project/Internship, the student will be issued ‘Certificate Letter’ subject to;

a. Student submitting detailed report of the assignment carried out.

b. Confirmation by the supervisor of the student in the company and the HOD from the institution that the
student has satisfactorily completed the assigment.

Details to be filled by HR Department of TKAP

Approval Ref. Code

Duration Start D D M M Y Y Y Y End D D M M Y Y Y Y

Student ID No. Department

Unit Shift

Project Guide Nam Designation

HR Approval

Signature with
date

Name

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