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Gujarat Energy Research and Management Institute

(www.germi.org)

Application Form for Summer Internship Programme-2013


1. Name: __________________________________________________________________
2. Home Address: ________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Paste a recent passport size


photograph

3. Home Telephone No.: _________________________________________________


4. Mobile No.: _____________________________________________________________
5. Email Address: ________________________________________________________
6. On what date could you start your project work at GERMI: ________________________________________________
7. Do you have any planned summer vacations that would take you out of work in between? If yes, on
which dates:
___________________________________________________________________________________________________________________
8. High School (mention percentage of marks from Class X onwards):
Xth: _______________________________
XIth: _____________________________ XIIth: __________________________________
9. College (attending):
___________________________________________________________________________________________________________________
10. College Address:
___________________________________________________________________________________________________________________
11. Currently commencing what year of college? _______________________________________________________________
12. Current Stream of study: ______________________________________________________________________________________
13. Expected Graduation Date/Year: _____________________________________________________________________________
14. Career interest after college: __________________________________________________________________________________
15. Possible areas of interest at GERMI: (i)_______________________________________________________________________
(ii)______________________________________________________________________
(iii)______________________________________________________________________
Signature of Student:_____________________________

Date: ____________________

Place: ________________________
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Recommendation and Forwarding by Home Institute/University


It is certified that the above mentioned is a fulltime student at our Institute/College/ University and
she/he is recommended for summer internship program at Gujarat Energy Research and Management
Institute for a period of days / months from .. 2013 to 2013.

____________________________________________________________
Name of Forwarding Authority

____________________________________________________________
Name of the Institute

Note:

_______________________________________________
Signature of Authority

_______________________________________________
Seal of Institute

Please complete this form and attach your detailed resume. Resume should have all work
experience, as well as college classes (describing any lab work, research projects, etc.).

Internship Coordinator: Mr. Prashant Gopiyani


Ph.: 079-23275373

M: 08141800171

Email: Prashant.g@germi.res.in

Address: 1st Floor, Energy Building, Pandit Deendayal Petroleum University Campus,
Raisan, Gandhinagar, Gujarat 382007
Website: www.germi.org

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