NATIONAL INSTITUTE OF TECHNOLOGY MEGHALAYA

Bijni Complex, Laitumkhrah, Shillong-793003

Ph. 0364-2501294, FAX 0364-2501113

SUMMER INTERNSHIP PROGRAM 2024

Application Form

1. Dept. Applied for:

2. Topic & Proposed Supervisor: (in preference order)
Order Topic Proposed Supervisor

Photograph
I

II

3. Personal Details:
Name Aashutosh Savita
(In Block Letters)
Date of Birth 09 - 04 - 2003 Gender Male
4. Name of Current Institution Madhav Institute of technology and Science
(Enrolled)
Present Address : Shivaji Nagar Aamkho Lashkar Gwalior Madhya Pradesh

5. Address with contact Permanent Address: Shivaji Nagar Aamkho Lashkar Gwalior Madhya
details Pradesh

Mobile No: 7000857280 Email: aashutoshsavita09@gmail.com

6. Educational Qualification:
Name of Name of Year of Percentage of marks/CGPA
Institute/College/School Board/University/Institute passing

10th Govt Jiwajirao Higher State Board 2018 82.8 %

secondary School
12th Govt Jiwajirao Higher State Board 2020 79.4 %
secondary School
Semester/Year 1st 2nd 3rd 4th 5th 6th
B.Tech. / B. Tech Madhav Institute of 2025 8.21 6.68 7.1 7.5 8.0 Res
B.Sc. Technology and Science 7 0 8 ult
not
dec
lare
d
M.Tech. /
M.Sc.

7. Hostel Accommodation required: Yes/No_________

 NATIONAL INSTITUTE OF TECHNOLOGY MEGHALAYA
Bijni Complex, Laitumkhrah, Shillong-793003
Ph. 0364-2501294, FAX 0364-2501113

8. Any Achievements/Awards that you would like to highlight:

9. Statement of Purpose (Write about the topic/project that you are interested and why do you
want to do this internship) (250 words)(Required)

10. Any Previous Record of Project Work (Have you done any kind of research/ project/
internship or fieldwork previously? If yes please mention details of research work) (200 words)

11. Declaration
I hereby declare that all the information provided in this application is correct and
complete to the best of my knowledge. If selected, I shall abide by rules & regulations of NIT
Meghalaya.

Place:
Date: Signature of applicant

12. Approval from the institution where studying:

I hereby certify that Mr./Ms. ………………………………………… is a bonafide student of

Department of ……………………….…………………………………………………….
at ............................................................................................... (name of Institute or
University). He/she is allowed to carry out his/her Summer Internship at NIT Meghalaya
during the period from ……..…………….. to …….……………

Date: (Signature with seal)

Place: Head of the Department / Institute
 NATIONAL INSTITUTE OF TECHNOLOGY MEGHALAYA
Bijni Complex, Laitumkhrah, Shillong-793003
Ph. 0364-2501294, FAX 0364-2501113

For Office Use ONLY

Recommendation
(Yes/No)

Proposed Project

Supervisor’s Name &

signature

Internship Dates

Please send the scanned copy (pdf) of duly filled application form through email to :
summer.internship@nitm.ac.in