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IIT Hyderabad Internship Application Form

This document is an application form for a non-degree short term internship program at the Indian Institute of Technology Hyderabad. The 3 page form requests information such as the applicant's personal details, academic history, intended activities and duration of stay. It also includes sections for recommendation from the applicant's home university and prospective faculty supervisors at IIT Hyderabad. Required enclosures include proof of enrollment, academic transcripts, CV and a letter of recommendation.

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Koruvada Narendra
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20 views4 pages

IIT Hyderabad Internship Application Form

This document is an application form for a non-degree short term internship program at the Indian Institute of Technology Hyderabad. The 3 page form requests information such as the applicant's personal details, academic history, intended activities and duration of stay. It also includes sections for recommendation from the applicant's home university and prospective faculty supervisors at IIT Hyderabad. Required enclosures include proof of enrollment, academic transcripts, CV and a letter of recommendation.

Uploaded by

Koruvada Narendra
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

INDIAN INSTITUTE OF TECHOLOGY HYDERABAD

Academic Section
Application Form
for Non-Degree Short term internship program

Name of Home University:

AFFIX
RECENT
Address of the Home University: PASSPORT
SIZE
PHOTOGRAPH

Planned Duration:

from d d m m y y y y
to d d m m y y y y
Department (Area of Interest):

Intended activities during stay at IIT Hyderabad under the internship:

A. Personal Data of the student:


Name: (in block letters)
(First Name)

(Middle Name)

(Last Name)

1
Father’s Name: (in block Letters)

Mother’s Name: (in block Letters)

Date of birth:
d d m m y y y y

City & Country of Birth:

Nationality:

Marital Status: Married


Unmarried

Do you have valid Passport: YES No

Address for Correspondence

Tel:

Fax:

E-mail:

Address of the University/Department:

Tel:

Fax:

E-mail:

2
B. Details of Study at Home University:
Department:

Degree ( Bachelors):

Date of Joining in Course:

Present year of studying:

Academic Year/Semester:

CGPA:

Place:
Date:
(Signature of the Applicant)

Application Recommended & forwarded By Home University

I hereby recommended the above student of this university to join in the short term internship at
IITH.

Date Signature

Name

Designation
Affiliation
Contact No
E-mail address

Seal

3
Prospected Faculty Supervisor/Mentor at IIT Hyderabad

1st option (Mandatory)

Name of Faculty Supervisor

Department

E-mail address of Supervisor

2nd option

Name of Faculty Supervisor

Department

E-mail address of Supervisor

3rd option

Name of Faculty Supervisor

Department

E-mail address of Supervisor

Enclosure Check List:


1. Recommendations/NOC Certificate from Home University.
2. Proof of Registration/Enrollment/Bona fide Letter/Id
Card from Home University.
3. Academic transcript/s
4. Curriculum Vitae(01-02 pages only).

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