APPENDIX-V EVALUATION SCHEME FOR INTERNSHIP—

(AGENCY SUPERVISOR)
Name of the Programme: MAPC: MA PSYCHOLOGY Course Code: MPCE-025
Study Centre: 13158: N.M.K.R.V. COLLEGE FOR Regional Centre: 13: BANGALORE
WOMEN, BANGALORE
Name of the Learner: COLETTE SOPHIA D'SILVA
Enrollment No.: 2002194491
Internal Marks by Agency Supervisor
Details Maximum Marks Marks Obtained
Sincerity and professional competence 10 10

Assessment (Case history, Mental Status 15

Examination, Interview, Psychological 10
Testing etc.)
Overall interaction with patients, clients & 5 5
employees and handling of cases
Total Marks 30 25

Comments, if any: ____________________________________________________________

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Signature ________________
Name of Agency Supervisor
___________________________
Dr Lakshmi TK
___________________________
Date:
Note:
1. At the end of the Internship the marks are to be given by the Agency Supervisor in the above
format and is to be sent to the concerned study centre address in a sealed envelope.
2. The Study Centre will then send the marks given by the Agency Supervisor along with the
marks given by the Academic Counsellor to the Regional Centre while sending the Intership
Report of the Learners to the Regional Centre.
3. The marks given by the Agency Supervisor and the Academic Counsellor will be totalled
and entered in the Award Sheet during the TEE of the Internship at the·Regional Centre;
The total internal marks are 60.

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APPENDIX-VIII CERTIFICATE
CERTIFICATE

This is to certify that Ms./Mr. _____________________________________________________

COLETTE SOPHIA D'SILVA
of MA Psychology Second Year (MAPC Programme) has conducted and successfully completed
the Internship in MPCE 015/ MPCE 025/ MPCE 035 (please tick one organisation/clinic/agency)
in the place __________________________________________________________________
MIND CARE INDIA

Name: COLETTE SOPHIA D'SILVA Name:

Enrollment No.: 2002194491 Designation:

13158: N.M.K.R.V. COLLEGE
Name of the Study Centre: FOR WOMEN, Place:
BANGALORE

Regional Centre:13: BANGALORE Date:

Place: BANGALORE

Date:

Signature of Agency Supervisor

Name: Dr Lakshmi TK

Designation: Founder, Senior Psychologist

Name of the Organization: The Mind Care

Address: Plot 3, Bharathi Avenue, New Perungalathur, Chennai 600063

Place: Chennai

Date: 11 January 2024

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