Internship/Placement Registration Form
Email address
NAME (Full name in Capital Letter)
Your answer
GENDER
Required
DATE OF BIRTH
MM
/
DD
/
YYYY
MOBILE NO.
Your answer
COMPLETE POSTEL ADDRESS
Your answer
ROLL NO
Your answer
CLASS & YEAR
10 th Standard %
Your answer
12 th Standard %
Your answer
SEM I %
Your answer
SEM II %
Your answer
SEM III %
Your answer
SEM IV %
Your answer
EXPERIENCE/TRAINING Completed, if any, with details of company and position:
Your answer
AREA OF INTEREST FOR INTERNSHIP/JOB PREFERENCE:
Your answer
YEAR OF PASSING *Only passing out Eligible
Your answer
HOW DID YOU CAME TO KNOW ABOUT INTERNSHIP PROGRAMME?
A copy of your responses will be emailed to the address you provided.
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