PK.FKK.PPLI.

TAWARAN (1)

INDUSTRIAL TRAINING PLACEMENT FORM

Reference No. : ..........................................................
Date

: ..........................................................

Asdarina binti Yahya

Industrial Training Coordinators
Faculty of Chemical Engineering
Universiti Teknologi MARA
40450 Shah Alam
Selangor Darul Ehsan
Phone: 03-5543 6377
Email: fkkuitm.eh221@gmail.com
Fax: 03-5543
6300
We hereby AGREE / DISAGREE* to accept your student to undergo the industrial
training in our company within the period of 18rd July 23th September 2016. The
particulars of the arrangement are as follows:
Students name
: ....................................................................................
Company name
: ....................................................................................
Company address
: ....................................................................................
..................................................................................
..
..................................................................................
..
Supervisors name
: ....................................................................................
Department

: ...............................................................................

.....
Monthly
allowance
(if
: ....................................................................................
Offer valid until**
: ....................................................................................

any)

Remarks (if any) :

Thank you.
Yours faithfully

(Signature)
Name: ................................................................................
Position: ............................................................................
Contact no.: ......................................................................

* Please cross the inapplicable

** Final date in which the student must send official notification to the
company / organization confirming placement. In the event that no
notification is sent, the above offer automatically becomes null and void.