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Gate Pass Cum Attendance Sheet RANA
Gate Pass Cum Attendance Sheet RANA
Gate Pass Cum Attendance Sheet RANA
GatePass
SSE/Concerned
Pleasearrangepracticaltraininginmarkedareasandsendattendancesheetdulysigned.Pleasealsoensurethatthe
traineeshouldbeequippedwithPPE's(safetyhelmet&shoesetc.)
RegistrationNo. TTC/DLW/17/1147
Name RANAPRATAPSINGH
FatherName BANSHBAHADURSINGH
Email RANAPRATAPS89@gmail.com
DateofBirth 05/07/1995
MobileNo. 8896217911
BranchName MECHANICALENGINEERING
CollegeNamewithcityname RAJKIYAENGINEERINGCOLLEGE,BANDA
YearinStudying ThirdYear
TrainingMonth JUNE
TrainingDuration(Inweeks) 6
FOROFFICEUSEONLY:
TrainingArea* ......................................................................................................................................
SignatureOfTrainingIncharge
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3/22/2017 GatePasscumAttendanceSheet
AnnexureI
FORMATFORDECLARATIONBYINTERNS
1.WithreferencetotheofferforinternshipvideletterNo...................................................dated.........................,Iherebyundertakethefollowing:
2.Iwillbedoinginternshipfrom...................................to..................................atDieselLocomotiveWorks(DLW),Varanasi.
3.Iamnotentitledtoanyremunerationintheformofstipend,salaryorallowancesofanykindbytheDLW.IamalsonotentitledtoanypassorPTOfrom
IndianRailways.
4.IwouldabidebyallGeneralrulesandregulationsofdisciplineandconductattheDLW,Varanasi.
5.IamliabletocompensatetotheDLWforanylossordamagetoequipmentandfittingsthatmaybecausedduringthecourseoftraininginworkshopsetc.
6.IwouldnotbetreatedasemployeeofIndianRailwaysandassuchwillnotbeentitledtoanycompensationordamagefromtheDLWforanyinjurytome
ortomypropertyetc.
7.IagreetobeundertheadministrativecontrolanddisciplineoftheTechnicalTrainingCentre,DLW,Varanasi.
8.IwillnotclaimanyadvantageforemploymentinIndianRailwaysinfutureonthebasisoftheinternships.
Date:.....................................
Name:....................................
Institute:...............................
Course:..................................
DeclarationbytheGuardian/Parent
........................................................undertakestoindemnifyDLW,VaranasiforanylossordamagetoequipmentandfittingsthatmaybecausedbyMr/Ms(
............................duringhis/herinternshipwithIndianRailways.
(AuthorisedSignatory/SignatureofGuardian)
NameoftheGuardian/Parent:.
RelationwithTrainee(Son/Daughter/OtherPleaseSpecify)........................
AddressoftheGuardian/Parent:.
ContactNo.(Mobile/Landline).....................................................................
Email(ifany).....................................................................................
NameofTrainee:RANAPRATAPSINGH RegistrationNo.:TTC/DLW/17/1147
TrainingMonth:JUNE BranchName:MECHANICALENGINEERING
DeclarationforInternship(bytrainees)
Iherebydeclaredthat:
1.Ialwaysusesafetyequipmentslikesafetyhelmet,safetyshoe,andlabcoat(forladies)duringtrainingwhichwillbearrangebyme.
2.AsIenteredinDLWpremises,Iwillfollowtheallrulesandbylawsoftraining.
3.Asavocationaltrainee,IwillnotharmtheDLWproperties.
4.Duringtrainingperiod,Iwillfollowtheinstructionsgiventomebytheinstructors/trainingincharge.
5.Iwillattendthetrainingregularly.
6.Iwillneverinterrupttheworkbygatheringwithothertrainees.
7.ThisiswellknowntomethatifIdoindisciplinebymyactivity,thiswillbeintimatedtomyguardianandinstitute.
8.Thisiswellknowntomethatmytrainingcanbepostpone/prepone/curtailorcancelonanytimebytheDLWadministration.
9.IwillfollowtherulesofDLWforquality,environment,healthandsafetymanagement.
10.InDLWpremisesespeciallyinworkshop,Iwilldotrainingonmyownriskandnoanycompassionclaimshallbedonebymeincaseofany
accident/casualty.
CandidateSignature
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3/22/2017 GatePasscumAttendanceSheet
Nameof
BranchName
trainee
FirstWeek: ShopName
Day . . . . .
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
Second
ShopName
Week:
Day
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
Third
ShopName
Week:
Day
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
Fourth
ShopName
Week:
Day
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
FifthWeek: ShopName
Day
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
SixthWeek: ShopName
Day
Date
Signatureof
concerned
SSE/SSO Fullname&sealofSSE/SSO
Note:EntryinworkshoponSaturdayisnotallowedduetohalfdayworkingOnlyadministrativeworkscanbedone(ifrequired)atTTCon
thisday.
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3/22/2017 GatePasscumAttendanceSheet
StudentAcknowldgement
NameofTrainee:RANAPRATAPSINGH RegistrationNo.:TTC/DLW/17/1147
TrainingMonth:JUNE BranchName:MECHANICALENGINEERING
Note:
1.Studentwillsendfilledformalongwithdeclarationformtothefollowingaddressthroughsimplepost/courier/registerspost/byhand
Principal
TechnicalTrainingCentre
DieselLocomotiveWorks,Varanasi221004
2.Checklistforpaperstobesend
a.GatePass
b.AttendenceSheet
c.CollegeRequestletter(inoriginal)
d.DeclarationbyInternandGuardian/Parent
e.IfTraineeisRailwayEmployeedependent.He/Shebringaattestedphotocopyofprivilage/schoolpass
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