DEPARTMENT OF TECHNICAL EDUCATION

ST JOSEPH’S POLYTECHNIC COLLEGE - DINDIGUL

INTERNSHIP BASIC DETAILS SHEET

Student Details

Name of the Student……………………………………………………

(Write Full Name in Capital Letters) Paste
Recent
Passport
Registration Size
No…………………………………………………………
Photograp
h
Branch………………………………………………………………….

Regulation ……………………………………………………………..

Academic Year ………………………………………………………..

Industry Details

Industry
Name…………………………………………………………………
…

Place ……………………………………………………………………

Name of the Faculty Supervisor …………………………………………………

Name of the Industry

Supervisor…………………………………………………

Head of the Department Faculty Supervisor

 FORM- I : STUDENT INTERNSHIP PROGRAM APPLICATION

1. Student Name:

2. Campus Address: Phone:

3. Home Address: Phone:

3a. Student email address:

4. Area of Interest: 5. Internship Semester: IV

6. Internship Industries:

Industry Name & Location Core Area

Industry-1

Industry-2

Faculty Supervisor Signature: Date .

Head of the Department Signature: Date .

Student Signature: Date .

Signature confirms that the student agrees to the terms, conditions, and requirements of the Internship Program
FO RM - I I : REQUEST LETTER FROM INSTITUTE TO INTERNSHIPPROVIDER

From

The Principal,
St joseph’s polytechnic college
RMTC colony
Natham road
Dindigul-624003
To
The General Manager (HR)
.......................................
.......................................

Subject: Request for 15 days IV-Semester Internship training for Diploma in ……………….
Program.

Dear Sir,
Warm greetings & regards from St Joseph’s Polytechnic College - Dindigul

AICTE has made Internship mandatory for all technical education students. Therefore
I request your good self to allow our following students for Internship training for 15
days in IV semester summer vacation in your esteemed organization. Kindly accord
permission and give at least one-week time for students to join training after
confirmation.

S. No. Name Roll No. Year Discipline

I request you to depute one industry

supervisor at your end and allot
suitable departments in your industry
for training. Faculty supervisors will
visit the internship students at regular
intervals.
With warm regards,
Yours sincerely,

FORM-III: RELIEVING LETTER OF STUDENT

From
The Principal or
The Head of the department,
 To
The General Manager(HR)

.......................................
Subject: Relieving letter of Student and Industry.
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 sole
guidance & directions:

S.No. Name of Students Roll No. Branch

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 daily.
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 basis of grading
i.e., Excellent, Very Good,Good, Satisfactory and Non-Satisfactory on the below
mentioned factors. The performance reportmay please be forwarded to the
undersigned on completion of training in sealed envelope.
S.No Name of Students Evaluation Ranking
.
a Attendance and general behaviour
b Relation with workers and
supervisors
c Initiative and efforts in learning
d Knowledge and skills improvement
e Contribution to the organization
Your efforts in this regard will positively enhance knowledge and practical skills of the students, your
cooperationwill 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,
The Principal or
The Head of the Department

FORM- IV: ATTENDANCE SHEET

Name & Address of Organization

Name of Student
Roll. No
Name of Course
Date of Commencement of Trg.:
Date of Completion of Training:
Initials of the student
Month
& 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
Year
Note:

1. Attendance Sheet should remain affixed in Daily Training Diary. Do not

remove or tear itoff.
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’ inRed Ink.

Signature of Company internship

supervisorwith company stamp/

seal

(Name ) Contact No.

FORM-V: STUDENT’S DAILY DIARY/ DAILY LOG

FORM-VII: STUDENT FEEDBACK OF INTERNSHIP (TO BE
FILLED BYSTUDENTS AFTER INTERNSHIP
 COMPLETION)

Student name: Date:

Industrial Supervisor: Title:
Supervisor Email: Internship is: Paid: Unpaid:

Address of Internship Provider/Industry/Organization:………………………………

Faculty Supervisor: Department Dates of Internship: From To

***Please fill out the above in full detail***

Give a brief description of your internship work (title and tasks for which you were responsible):

Was your Internship experience related to your major area of study?

------------------Yes, to a large degree--------Yes, to a slight degree-------------------No, not related at

all indicate the degree to which you agree or disagree with the following statements.

Strongly No Strongly
This experience has: Agree Disagree
Agree Opinion Disagree
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
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? (Circle one). (Satisfactory/
Good/Excellent)

Give suggestions as to how your internship experience could have been improved. (Could you
have handled added responsibility? Would you have liked more discussions with your professor
concerning your internship? Was closer supervision needed? Was more of an orientation
required?)

Student Signature The Head Of The Department

Faculty Supervisor

FORM-VIII: INDUSTRY SUPERVISOR EVALUATION

OF INTERN- 20 MARKS
 Student name Date: Work

supervisor Title:

Company/Organization:………………. Internship address:

Dates of Internship: From To

Please evaluate your intern by indicating the frequency with which you observed the
following behaviors – 20 marks (Excellent- 1 mark, Good- 0.5 mark, Satisfactory- 0
mark)

Parameters Excellent Good Satisfactory

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

Overall performance of student intern (circle one):

(Excellent / Good/
Satisfactory)Additional comments, if any:
Signature of Industry supervisor HR Manager …………………….
 FORM-IX: EVALAUTION OF INTERNSHIP BY INSTITUTE
FACULTY SUPERVISOR-15 MARKS

Evaluation(I)------------------------------------------------------------------------------------

1. Name of Student Mob. No.

2. Roll No.
3. Branch/Semester Period of Training
4. Home address with Contact No.
5. Address of Training Site:

6. Address of the Internship Industry provider Training

Providing Agency:
7. Name/Designation of Training in-charge---------------------------------------------
8. Type of Work
9. Date of Evaluation
Each 3 marks
a) Attendance: _ (Satisfactory /Good/Excellent)

b) Behavior
c) Practical knowledge gained
d) Diary inspection
e) Feedback of the student

Overall grade: (Satisfactory /Good/Excellent)

Signature of Faculty Mentor Signature of Internship Supervisor

(Industry)

With date and stamp

*Photocopy of the attendance record duly attested by the training in-

charge should beattached with the evaluation Performa.