photo

Student’s name : ___________________________________________

ID. No : ___________________________________________

IC. No : ___________________________________________

Tel/HP No : ___________________________________________

Programme : ___________________________________________

Year : ________________ Semester : _________________

Home Address : ___________________________________________

___________________________________________

___________________________________________

Academic Advisor : ___________________________________________

Place of training Address : ___________________________________________

during practical training
___________________________________________

___________________________________________

___________________________________________

Name of Supervisor in- : ___________________________________________

charge
Duration of training : From: _________________to __________________
Code of Conducts

Student must adhere to the following rules and regulations during the training:

1. Regulation
Student must comply with all applicable laws and regulations and directives as determined by
the direction of the management/administration the students undergo industrial training.

2. Discipline
Student must show discipline and character. Student must strive and provide the assistance
needed by the management.

3. Attendance/Absence
a. Every student must make him / herself available throughout the working hours as
specified by the organization.
b. Students are not allowed to take any personal leave without permission given by the
company and college. Any personal leave will affect the attendance marks with maximum
10 marks for taking more than 4 days of personal leaves.
c. Medical certificate is only accepted from the government clinic and government hospital
only. All medical certificates should be patched in the Industrial Training Log Book.
d. In the case of medical leave more than 14 days the students are advised to extend their
internship to the following semester to meet the academic regulation.
e. The company has the right to grant additional leave if the company business operation
closes temporary however students need to submit the company notice of closure to
college together with Form D.
f. All personal leaves and medical leaves should be recorded in Form D.

4. Student Card
Students should always wear college student identification card.

5. Conversion of Training
Students are not allowed to change the location of the training set, except with the
permission of the Industrial Training Unit. Conversion without permission will be subjected to
disciplinary action.

6. Log Report
a. Student must fill in their log report to prove their work/ activities that have been
completed for the day.
b. Writing must be in English, neat and legible.
c. Students must bring the log report to the training everyday and obtain weekly employer /
supervisor signature.

7. Confidentiality of Organization’s Information

a. Students are prohibited from revealing any classified information pertaining to the
organization.
b. Students are also prohibited from copying, printing or taking pictures of any document or
equipment deemed secret by the organization.
 KOLEJ PROFESIONAL MARA BERANANG

INDUSTRIAL TRAINING (ITR 3628)

ASSESSMENT RUBRICS

STUDENT’S NAME

STUDENT’S ID

PLACE OF TRAINING

COURSE LEARNING OBJECTIVE

CLO 1 Apply the academic theory and knowledge learned towards real working environment in
industries/organizations (C4, PLO2)
CLO 2 Relate the knowledge learned and the experience obtained during industry placement;
(A4, PLO5)
CLO 3 Practice the skills and techniques directly applicable to students' careers from practitioners
in the students' areas of specialization. (P2, PLO3)
CLO 4 Perform the tasks effectively forcontinous professional development and life long learning
(A2, PLO9)

NO CRITERIA ALLOCATED SCORE GAINED

(%) (%)
1 STUDENT’S LOGBOOK 15
2 STUDENT’S ATTENDANCE 10
3 EMAIL 5
4. PRESENTATION 20
5. REPORT 20
6 INDUSTRIAL SUPERVISOR EVALUATION 20
7. INDUSTRIAL TRAINING MANAGEMENT 10
TOTAL 100
GRADE OBTAINED
GRADE POINT OBTAINED

Notes : Please enclosed together student”s performance & attendance & ITR presentation
marking sheet.

Signature : ……………………………………………. Date : ………………………………

Advisor’s Name : ………………………………………………

1.0 LOG BOOK ( 15% )

 Sum of marks required each week in ∑ a

 Max. score : 25 points [ 5 (max score point) x 5 ]

NO Criteria 1 2 3 4 5

1 Report is prepared daily.

Gained = ∑ a x 15
2 Report is outlined precisely.
25
3 Clear and understandable report.
=
%
4 Report is authorized by supervisor.

5 Related to job scope/ task(s)

∑a

2.0 ATTENDANCE (10 %)

Total of absenteeism (Days) Mark(s)

0 10

1 9
Gained =
%
2 8

3 7

≥4 0

3.0 E-MAIL ( 5%)

 Sum of marks required each week in ∑b

 Max. score : 80 points [ 5 (max score point) x 16 e-mail ]

WEEK NO SCORE WEEK NO SCORE

Gained = ∑ b x 5
1 9 80
2 10
3 11
4 12 = %
5 13
6 14
7 15
8 16
∑b
 4.0 PRESENTATION (20%)

MARKS MARK
REMARKS
CRITERIA OBTAINED
1 2 3 4 5
1. Content The The The The presenter
presenter presented presenter was extremely
was not was was organized in the
organized at organized organized delivery of this
all. There did in the in the presentation.
not appear delivery of delivery of Information was
to be any this this presented in a
sequence presentatio presentati logical,
nor order to n. The flow on. The interesting
the of the flow of the sequence that
information presentatio presentati was easy to
presented. n was on was follow.
unclear and easy to
confusing follow.
because
student
tended to
“jump
around”
from topic
to topic.
2. Visual Schematics The visual Visual aids The visual aids
Aids or visual aids aids were (slides, physical
did not contributed helpful in props white
improve the little to the some board, etc.) were
explanation, presentatio parts of cleverly chosen
were difficult n and it is presentati and presented
to read, or not clear on which improve
were why they understanding of
inadequately were the topic.
produced. chosen
3. Verbal Information Information Informatio Information is
Communica is lacking / is not n is communicated in
tion unclear and presented presented a thorough
communicat in a clear in a clear manner and
ed in such a manner manner ideas are
way that the and many and the expressed in
audience details are audience such a way that
cannot missing has a the audience can
understand related to general clearly
the purpose the understan understand the
of the evidence ding of the evidence work
evidence work and evidence and internship
work and internship work and experiences
internship experiences internship
experiences experience
s
4. Fluency Presenter is Presenter is Presenter Presenter is very
and Clarity not fluent not fluent is fluent fluent and voice
and voice is and voice is and voice is easy to be
not clear slightly not is slightly heard clearly
clear easy to be
heard
clearly
5. Non- i) Student i) Student i) Student i) Student able to
verbal unable to makes makes use excellent
Communica use body minimum suitable body language
tion language body body (eye contact and
(eye contact language language gestures) with
and (eye (eye everyone
gestures) contact and contact
towards the gestures) and
audience toward the gestures)
audience may focus
but on
happens audience
only a few
times.

ii) Student ii) The ii) Student ii) Student is

does not student is seems completely
seem at all somewhat pretty prepared and has
prepared to prepared, prepared obviously
present but it is but might rehearsals
clear that have
rehearsal needed a
was lacking couple
more
rehearsals

iii) In iii) Casual iii) Wear iii) Very

appropriate attire pieces of professional and
attire formal formal attire
attire

6. Not able to Able to Able to Able to respond Able to fully

Understand understand understand understan to questions well understand
and respond and respond and answer d and and respond
to questions to a question questions answer to questions
but not questions very well
able to satisfactor
accurately y
answer the
question

TOTAL ∑ d = (SCORE NO : 1 + 2 + 3 + 4 + 5 + 6 )

Gained : ∑d x 20 =
25 %
6.0 REPORT (20 %)

MARKS
NO. ITEM
Allocated Obtained
i. Student’s Biodata 1
Name
Identification Card No.
Student No.
KPM’s Address
Age & Gender
Name & Address of Company
Date & Duration of Industrial Training
ii. Acknowlegement
iii. Declaration
iv. Abstract 1

v. Table of Content 1
1.0 Introduction to Industrial Training
1.1 About the Program 2
1.2 Objective of Industrial training report
2.0 Company Background 4
Name of Company
Address
Telephone & Fax. No.
Company Registration No.
Type of Business
Status of Company (Sole Proprieter / Partnership / Sdn. Bhd.)
Owner / Board of Directors
Company Organisational Chart
Vision & Mission of Company
3.0 Observation on policies
-management 4
-Operation 4
-marketing 4
-finance 4
-technologies gained / new knowledge 4

Work experience / Description of tasks (weekly activities)-

4.0 state down any new knowledge gain 20
5.0 Relevance of courses taken at KPM to the present work
experience (Minimum of 5 courses) 20
6.0 Interaction with others:
6.1 - 2 Interviews with: 5
i. Executive level staff
ii. Supporting staff
6.2 Describe one role model from the company 5
7.0 Problem / suggestions ( minimum of 5 relevant ideas)
i. Problems 5
ii. Suggestions 5
8.0 Conclusion
i. Benefits 4
ii. Recommendations 3

9.0 Appendix 4
TOTAL 100 ∑e

Gained : ∑e x 20 =
100 %
4.0 INDUSTRIAL SUPERVISOR EVALUATION (20%)

NO OF POINTS
SCORE (1) SUBTOTAL (1) X (2) Gained =
GAINED (2)
1
∑c x 20
2
5 x 10 (No of Criteria)
3
4
= %
5

∑c =

7.0 INDUSTRIAL TRAINING MANAGEMENT (10%) - Assessed by Industrial Training Officer

 Comply to dateline
o Submitting information and documentation.
 Comply on every activity and task given to complete internship.
 No changes to industrial training places (unless with strong justification and consent from KPM)

Gained = %
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Day No: _____

Date/ Time Activities

SUPERVISORS REMARKS

_________________________________________________

_________________________________________________

Company
Stamp
 Form A

KOLEJ PROFESIONAL MARA (KPM)

INDUSTRIAL TRAINING
STUDENT’S DECLARATION TO COLLEGE

I........................................................(Name),......................................(IC.No)
..................................... (ID.No) hereby declare, during my industrial training period,
that:
I will abide by any rules and policies set by:

i. The company and industries including the dress code and other matters as well
as to be on my best behaviour during training.

ii. The College and comply to the program requirements.

I am responsible for any related matters such as accommodation, transportation, daily

necessities and others.

I have informed my parents / guardian in respect of this program as well as any related
matters such as company name and address, the name of the training supervisor,
supervisor of college, residential address and others.

I acknowledge that the company selected for training in the industry is not my own or
my family's company.

I agreed with the regulation set out in the KPM & KM Student Disciplinary Handbook and
The Academic Regulation Handbook. If I violate these rules I am prepared to receive the
sentence in accordance with the guidelines set out.

KPM and MARA are not responsible directly or indirectly for any injury, harm or accident
resulting in death.

Student Signature : …………………………………………….

Student Name : ……………………………………………

Witnesses by;
Advisor Signature : ……………………………………………

Advisor name : ……………………………………………

Advisor Telephone No : ……………………………………………
Advisor Email : ……………………..……@mara.gov.my
 Form B

KOLEJ PROFESIONAL MARA (KPM)

INDUSTRIAL TRAINING

STUDENT’S DECLARATION TO INDUSTRY

I........................................................(Name),.......................................(IC.No)
...................................... (ID.No) from Kolej Profesional MARA, in return for the
opportunity to undergo training in your organization / industry, hereby declare:

1. That I will comply with all rules and regulations imposed and enforced by the
company.

2. I will not disseminate / disclose any information concerning the company or

any related organization, whether the information obtained directly or indirectly
during the training period, subject to paragraph (3) below.

3. Restrictions on dissemination of information do not apply to bona fide made by

the college for academic purposes and related matters.

4. That I, or anyone on my behalf, will not make any claims on any injuries and
misfortune on myself during training which is caused by my own negligence.

……………………. ….………………………..
Date Student Signature

……………………………
Student Name

.………………….……. ……………………………….
Company Stamp Witnesses Signature (Supervisor)

……………………………….
Witnesses Name (Supervisor)
 Form C

KOLEJ PROFESIONAL MARA

INDUSTRIAL TRAINING
CONFIRMATION OF STUDENT INTERNSHIP
SECTION A – Completed by Student
Student’s Name:
ID No: I.C No:
Course:
Home Address: Full Company Name and Address:

Tel: Tel:
Signature: Date: Fax:

SECTION B – Completed by Supervisor

I hereby certify that _______________________________________ (Name of Student)

has signed up to undergo industrial training at our company on ______________ (date)
in ___________________________________________________ (Full Company Name).

Signature: Company stamp:

Name:

Position:

Date:

Please return this form within one week on the date of the self-report to Industrial
Training Officer.
 Form D
KOLEJ PROFESIONAL MARA
INDUSTRIAL TRAINING

ATTENDANCE REPORT

Student’s Name : ..………………………………………………….…….

IC No. : ..………………………………………………….…….

ID No. : ..………………………………………………….…….

Program : ..………………………………………………….…….

Duration of training : From ................................ To ......................................

No. Item day

1. Attend (Minus public holiday) ____ days

Absent with Medical Certificate / Death Certificate (Next Of Kin)

2.
i) Warded / Accident / Infectious Disease / Death

NO.OF SUPERVISOR
DATE OF MC/DC REASON
DAY SIGNATURE

TOTAL NO. OF DAY

Confirmed by:

Signature : ..………………………………………………….…….

Name : ..………………………………………………….…….

Position : ..………………………………………………….…….

Company Stamp : ..………………………………………………….…….

* Public holidays will not affect attendance marks

 Form E
Kolej Profesional MARA
Industrial Training Program
Workplace Supervisor Assessment Form

(STUDENT PERFORMANCE)
Student’s Name : .............................................................. IC No.: ...................................................................
Program : ............................................................. I.D No. : ……………………………………………………………..
Duration : From …………..…..... To ………..….........…
Company’s Name : ................................................................................................................................................
Place a cross in one box in each row indicating the level of achievement in each category. 5 indicates a high achievement in
the category and 1 indicates a low achievement. Please indicate any categories which you believe to be irrelevant for your
workplace.

NO. CATEGORIES 5 4 3 2 1
1. Interest in Work High interest in job, More than average Satisfactory interest & Interest spasmodic. Little interest for
very enthusiastic. interest & enthusiasm enthusiasm of job. Occasionally enthusiasm for job.
for job. enthusiastic

2. Initiative Self-starter. Asks for Acts voluntarily in most Acts voluntarily in Relies on others. Must Usually waits to be told
new jobs. Looks for matters. routine matters. be told frequently what what to do next.
work to do. to do.

3. Organization and Does an excellent job Usually organizes work Does normal amount of More often than not Consistently fails to
Planning of planning and well. planning and fails to organize and organize and plan
organizing work. organizing. plan work effectively. effectively.

4. Communication Excellent. Good. Average. Poor. Very poor.

Skills Easily understood and Usually understood and Sometimes understood Difficult to understand Rarely understood. Can
usually understands understand others. and sometimes and often fails to never immediately
others. understands others. express clearly what clearly express his/her
he/she requires. Often requirements and
misunderstands others. rarely understands
others.

5. Time Management Excellent. Good. Average. Poor. Very poor.

Work always Completes work on Work usually Work rarely completed Work never completed
completed on/before time and of good completed on time. on time. on time or at all.
schedule and is of a standard.
high standard.

6. Ability to Learn Exceptionally quick. Quick to learn. Average. Slow to learn. Very slow to learn.

7. Quality of Work Very thorough in Usually thorough. Work usually passes More than average Work usually done in
performing work. Good work. Few errors. review. number of errors for a careless manner.
Errors very few. Has normal numbers of trainee. Makes errors often.
errors.

8. Dependability Can always be Can usually be Can be depended upon Somewhat unreliable: Unreliable.
depended upon in any depended upon in most in routine situations. needs above average
situation. situations. checking.

9. Relationships with Always works in Congenial & helpful. Most relations with Difficult to work with at Frequently quarrelsome
Others harmony with others. Works well with others are harmonious times. Sometimes and causes friction.
An excellent team associates. in normal antagonizes others.
worker. circumstances.

10. Creativity Continually seeks new Frequently suggests Has average Occasionally comes up Rarely has a new idea:
and better ways of new ways of doing imagination: has with a new idea. is not very imaginative.
doing things: is things: is very reasonable number of
extremely innovative. imaginative. new ideas.

Any further comments:

______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Signature ……………………………………………………………….
Name ……………………………………………………………….
Position ……………………………………………………………….
Company Stamp ………………………………………………………………. Date: ……………………….

* (Please return this form within one week from the date of completion of training).
 Form F

____________________________
____________________________
____________________________
____________________________
(Company Name & Full Adress)

To:
Director
Kolej Profesional MARA
________________________________
________________________________
________________________________
(Attn: Industrial Training Officer)

Sir/Madam,

INTERNSHIP COMPLETED VERIFICATION

Kindly be informed that the following person has completed internship program at our
company. The details are as follows:

Student’s Name :
IC No :
ID No :
Date of completion :
Program : Diploma in..................................................................

Thank you

Yours faithfully,

.................................................
Name :
Position :
Company Stamp :
 Form G

SURVEY COMPANY FORM INDUSTRIAL TRAINING

(To be completed by the students on the last day training industry)

1. Company’s Name: _______________________________________________________________

2. Company‘s Address: ____________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

3. Phone No: __________________________ ______ Fax No: ___________________________

4 Company’s Email : _______________________________________________________________

4. Person in charge: _______________________________________________________________

5. Field Services Company: __________________________________________________________

6. Industrial Training Allowance: RM ________________________________________________

7. Facilities: (Tick √)

Accomodation

Transport

Refreshment

Prayer / prayer time

Job opportunities after industrial training

Other facilities (Please specify) ……………………………………………..……………………………………

8. The number of students who usually taken at a time: ____ person

9. The relationship between student and supervisor training and management industry:
Very Good / Good / Fair / Satisfactory / Poor*

10. The level of training / guidance given by the company:

Very Good / Good / Fair / Satisfactory / Poor*

11. The security aspect is emphasized by the organization: Yes / No *

12. Word / Training involve working outside the office: Yes / No *

13. Word / Training involves more time: Yes / No *

14. Suitability as a training ground where the industry course:

Suitable / Not Suitable*

Student’s Signature :
To be filled by Industrial Training Officer
Student’s Name : _______________________________

ID No: _________________

Industrial training session :

* Delete where not applicable