Format of Application

1. Name :
2. Father’s Name:
3. Date of Birth:
Photo
4. Gender : Male Female
5. Email Id :
6. Contact No :
7. Educational Qualification:

Degree Board/University Subjects Percentage Year of Passing

8. Specialization:
9. Duration of internship:
10. Time period of Internship:
Place:……………………
Date:…………………….. (Signature)

Certificate of Authorization
Certified that Ms/Mr………………………………………., who is a bonafide student of
…………………………..at…………………………………………………………department of
…………………………………………………………..University and has been officially

nominated for internship at Jharkhand Space Applications Centre, Ranchi during

…………………….. to …………….....

Place:…………………… (Signature of the Head of the Department)

Date:…………………….. Name:………………………………………
Designation:………………………………..
(Official Seal)