Board Of Research In Fusion Science & Technology National Fusion Programme (NFP)

Internship Scheme t The Institute For Plasma Research! "andhinagar

http:&&nfp.pssi.in

(Application Form)
(To be filed in by the student) Name of the Student: Date of irth: (day/month/year) Name of the course you are re"istered# please specify ($.%.&$.Tech.&$.Sc.&$.'.A.&$. .A#) Discipline# please specify your PG degree Specialization Tentati*e Date for startin" the pro+ect at ,-. (day/month/year) Duration of the pro+ect# as specified in your -0 curriculum Name and 'ontact number& %mail of your -ro+ect 0uide# in your ,nstitute &3ni*ersity Name and Address of ,nstitute&3ni*ersity# 5here re"istered for abo*e course -ostal Address for 'ommunication: %mail : -hone : $obile : 11..1. Months (please specify the number of months) From: 1111.. (dd/mm/yy) to .(dd/mm/yy) Paste your recent passport size photograph here.

1. 2. !.

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Academic performance in abo*e said re"istered course. a) Total 8 of mar9s# obtained so far in the abo*e course : b) %:pected month ; year of completion of the course : Academic -erformance before the -ost 0raduation
"rade Institution#Board Su$%ects &ear of Passing ' of mar(s

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0raduation 'lass <,, 'lass <

Note: Please do not send photocopies of the marks sheets etc Marks !ill be "erified at the time of #oining the $nternship scheme.

, affirm that all the abo*e=mentioned information is true and correct# and also , ha*e attached t5o recommendation letters from t5o different faculties in sealed en*elopes. Date: 11111.. Si"nature of the Student The applicant is a bonafide student of this department&,nstitute durin" the academic year 27>>>= 27>>> ?e&She is "ettin" financial support# not getting financial support# from any or"ani@ation. Date: 111111
Affice Seal Name ; Si"nature of ?ead& -ro"ramme 'oordinator

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> For5ardin" authority may please note that ANBC TDA applicants can be offered ,nternships from the same Department&Discipline of an ,nstitute&'olle"e&3ni*ersity.