INDIAN NATIONAL ACADEMY OF ENGINEERING

PROFORMA FOR MENTORING OF ENGINEERING STUDENTS

PART-I
(To be filled in by the Engineering Student)
(No direct correspondence from Engineering Students will be entertained at INAE Office)

1. Name of Student :

2. Name and Address of :

Institution/University

3. Discipline and Year :

4. Address, Telephone No., :

Email address of Student

5. Academic Record of Student :

(Eligibility minimum 75% or
minimum 7.5 CGPA)

Class/Y School/College/Institution/University Discipline Marks/Division/

ear Grade/CGPA*
X

XII

1st Year
B.E./
B.Tech
2nd Year
3rd Year

* at the time of application. Please note in the absence of the formula not provided by the
University/Institution, the CGPA will be multiplied by 0.90 to determine the percentage of marks obtained
for consideration of merit by the Committee.
b) Other Academic/Technical Contributions:
i) Projects carried out with titles

ii) Publications in journals/conferences/workshops

iii) Participation in engineering/technical competitions showing evidence of novelty/creativity

/innovativeness etc.

iv) Other academic achievements

6. Name of Mentor :

7. Name and Address of :

Organization where INAE
Fellow (Mentor) is serving/
Contact Address of Mentor
(if retired)

8. Title and Abstract of work to : Please enclose as Annexure I

be undertaken and likely
benefits of the proposed
study

9. Statement of Purpose &

Motivation

10. Duration and Period of :

Mentoring
 Undertaking by Engineering Student

I have not applied for mentorship under any other INAE Fellow under this scheme

Date : Signature of the Engineering Student ______________________

Signature of Dean/Head of the Department

of concerned EngineeringCollege and Seal

Name

Designation and Address

E-Mail Mobile

PART –II

(To be filled in by the INAE Fellow)

1. Name and Designation of Mentor (INAE Fellow)_____________________________________

_____________________________________________________________________________

2. Engineering Discipline and Field of Specialization____________________________________

__________________________________________________________________________

3. Contact Address, Telephone No., Fax, E-mail_______________________________________

___________________________________________________________________________

4. Institutional Affiliation__________________________________________________________
____________________________________________________________________________

5. Name and Institution of Student whom you have identified for mentoring_________________
_________________________________________________________________________

6. Period and Duration of mentoring*_________________________________________________

7. Name and Address of Institution/University/Industry/Organization where the Engineering

Student shall be mentored ______________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Date : Signature of the INAE Fellow _______________

Place :

*Please note: A Fellow can mentor up to two engineering students who will not be from the same
institution/college/university/organization