MAHENDRA COLLEGE OF ENGINEERING, SALEM-106.

CONSENT FORM

Name of the Student:

Register No:
Department:
Year / Class & Section:
Tour / Visit:
Destination:
Date from: ……………………. To …………………
Departure Point:
Return to station on: ……………….. Time: ………….
Amount collected:

IV / Tour Coordinator HOD

PARENTS AND STUDENTS DECLARATION

Date:

This is to accept that my son / daughter ……………………………………………….......

(Reg. No : ………………………………………………………….) studying in
.......…………….………………………………………………………………………….
to………………...…..……………………………………………………………………
……… on ....………………… .I assure that he / she will not create any disturbance in
the trip and he / she will cooperate to the faculty by all means. I also assured that my son
/ daughter will not involve in any indiscipline action in the industrial visit.
I accept that college is not responsible for any grievances, accidents and natural disasters
in the industrial visit.

Parent Mobile No. :

Signature of the student Signature of the parent

PARENT’S / GUARDIAN’S CONSENT

I agree to send my ………………………. to ……………………. who is staying in

hostel/ with me, for the entire tour programme.

Parent’s / Guardian’s Signature