ANNEXURE – I

UNDERTAKING

I, Mr. /Ms.……………………………………….....................................................................,
Programme:……………………………………, School : …………………………, student of MIT
Academy of Engineering (MIT AOE), permanent resident of
………….............……………...........................................................................................................
.........................................................................................................................................................
.........................................................................................................................................................
Phone No: ............................................................... (Give permanent home address with
telephone no.), do hereby undertake on this the……… (Day), of.................. (Month)..............
(Year), the following
1. I, hereby, declare that, the entries made by me in the Application Form are complete and true
to the best of my knowledge and based on valid records.
2. I, hereby, promise to abide by the admissible rules and regulations, concerning discipline,
attendance, etc. of the Institute (MIT AOE), and also to follow the Code of Conduct prescribed
by the Institute / Industry in which I am going to take the internship.
3. I, hereby undertake to maintain the name of the Institute in high levels during my period as
intern in whichever Institute / Industry I am given an opportunity to undergo technical training.
4. I, hereby declare that I will take care of my academic activities also during the internship.
5. I, hereby declare that I will maintain confidentiality and not disseminate / share any
information related to the Institute / Industry to third parties.
6. I, hereby undertake to be responsible for maintaining the security of properties belonging to
the Institute / Industry.

Date: ___________________ Place: ___________________

Signature of Student: ______________________

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 ANNEXURE – II
Application for Internship Program
Sr. Particulars
No.
1 Name of the applicant
2 Gender

3 Class & School

4 Date of Birth & Age (as on date)

5 Roll Number & PRN

Address for correspondence with
6 mobile / telephone number and
email-id
Name & address of the Institute /
7
Industry
Core Domain of Institute /
8
Industry
Contact details Supervisor / HR
9 Mobile / Telephone number and
email-id
10 Period of internship 24-26 weeks

11 Stipend amount if any

Signatures

Applicant Student Recommended by SLIP Mentor

(Project guide/co-guide from SEE)

Verified by School SLIP Coordinator Approved by Dean – School of Electrical

Date: Engineering

2
 ANNEXURE – III
REQUEST LETTER FROM INSTITUTE TO INTERNSHIP PROVIDER

To
.......................................
.......................................

Subject: Request for Semester Long Internship for B.TECH degree program

Dear Sir,
Our students have undergone internship training in your esteemed organization in the
previous years. I acknowledge the help and the support extended to our students
during the training.
OR
(For first time industry) As per AICTE mandates, internship is now a compulsory
competent of education for all technical education students.
In view of the above, I request your good self to allow our following students
for undertaking practical training in your esteemed organization. Kindly accord your
permission and give at least one-week time for students to join training after
confirmation.
Roll Name PRN Year Discipline
No.

A positive communication will be highly appreciated.

With warm regards,
Yours sincerely,

Coordinator – SIP

3
 ANNEXURE IV

REPORTING LETTER OF STUDENT

To
.......................................
.......................................

Subject: Reporting letter of student to Institute / Industry

Dear Sir,
Kindly refer your letter / e-mail dated. on the above cited subject. As permitted by
your good self, the following students will undergo Institute / Industrial Internship in your
esteemed organization under your guidance.

Roll. Name of Students PRN Year & Discipline

No.

You are requested to evaluate the student’s performance on the basis of grading i.e.
Excellent, Very Good, Satisfactory and Non-Satisfactory on the below mentioned
factors. The performance report may please be forwarded to the undersigned on
completion of training in a sealed envelope.
Sr. No. Name of Students Evaluation Ranking
1 Attendance and general behavior
2 Relation with workers and supervisors
3 Initiative and efforts in learning
4 Knowledge and skills improvement
5 Contribution to the organization
Your efforts in this regard will positively enhance knowledge and practical skills of the
students and your cooperation will be highly appreciated. The students will abide by the
rules and regulation of the organization and will maintain a proper discipline with keen
interest during their Internship. The students will report to you on along with a copy of
this letter.
Yours sincerely,
Coordinator – SIP

4
 ANNEXURE – V

SUPERVISOR EVALUATION OF INTERN

Student Name: Date:

Work Supervisor: Title:
Institute/Industry:
Dates of Internship: From To

Please evaluate your intern on following factors: (Tick √ )

Parameters Needs Satisfacto Good Excellen
improvem ry t
ent
Professionalism and Behavior
Cooperation with co-workers and
supervisors
Interest in work
Learning ability
Emphasis on high-quality work
Readiness to take responsibility
Use of technical knowledge and
expertise
Display of creativity/originality
Problem Analysis
Communication

Punctuality
Time Management Skills
Overall performance of student intern (circle one):
(Needs improvement / Satisfactory / Good / Excellent)

Signature of Institute / Industry supervisor

5
 ANNEXURE VI : RUBRICS FOR THE EVALUATION OF SLIP
Item Mark for item
2-3 4-5 6 7 8 9-10
A. Professional skills 30%
1.1. Initiative and Student shows no Student picks up some Student shows some Student initiates Student has his own Innovative methods and
creativity initiative or new ideas at initiatives and/or new initiative and/or together discussions on new ideas creative ideas. analysis of
all. ideas suggested by others with the supervisor with supervisor and information/data. Possibly
(e.g. supervisor), but the develops one or two new develops one or two own the idea for the project has
selection is not motivated. ideas on minor parts of the ideas on minor parts of the been formulated by the
project. project. student.
1.2 Insight in Student shows no Student shows no insight Student is able to draw an Student is able to indicate Student is able to indicate Student knows how
functioning of another insight in functioning of in functioning of the organization chart of the the position of the team the responsibilities of the changes are realized in the
organization the organization. organization. organization. within the organization as different units within the organization.
a whole. organization.
1.3 Adaptation Student doesn’t adapt Student doesn’t adapt and Student knows the do’s Student accepts how thing Student is able to adapt to Student adapts easily to the
capacity and gives an impression gives an impression of and don’t in the new work go within the new work the new work work environment within the
of apathy or is often apathy or is often involved environment. environment. environment. limits of his personal
involved in disputes or in disputes or arguments. values.
arguments.
1.4 Commitment and Student is not Student has little Student is motivated at The student is motivated. The student is motivated The student is very
perseverance motivated. Student motivation. Tends to be times, but often, sees the Overcomes an occasional and/or overcomes an motivated, goes at length to
escapes work and gives distracted easily. Has work as a compulsory setback with help of the occasional setback on his get the most out of the
up regularly given up once or twice task. Is distracted from supervisor. own and considers the project.
work now and then. work as his “own” project.
1.5 Independence The student can only The student needs The supervisor is the main Student selects and plans Student plans and Student plans and performs
perform the work frequent instructions and responsible for setting out the tasks together with the performs tasks mostly tasks independently and
properly after repeated well-defined tasks from the the tasks, but the student supervisor and performs independently, asks for organizes his sources of
detailed instructions and supervisor and the is able to perform them these tasks on his own help from the supervisor help independently.
with direct help from the supervisor needs careful mostly independently when needed.
supervisor. checks to see if all tasks
have been performed.
1.6 Handling Knowledge and insight There is some progress in The student is able to The student is able to The student is able to The student has knowledge
supervisor's of the student (in the professional skills of adopt some skills as they adopt skills as they are adopt new skills mostly and insight on a academic
comments and relation to the the student, but are presented during presented during independently, and asks level, i.e. he explores
development skills prerequisites) is suggestions of the supervision supervision and develops for assistance from the solutions on his own,
insufficient and the supervisor are also some skills independently supervisor if needed. increases skills and
student is not able to ignored occasionally. as well. knowledge where
take appropriate action necessary.
to remedy this
1.7. Time management No time schedule made. No realistic time schedule. Mostly realistic time Realistic time schedule, Realistic time schedule, Realistic time schedule,
schedule, but no timely with some adjustments if with if necessary timely with if necessary timely
adjustment of time necessary (but not enough adjustments of times only. adjustments of both time
schedule if necessary. or not all in time) in times and tasks.
only.

6
Item
2-3 4-5
B. Self reflection on internship 10%
3.1 Report on self- Is not able to describe Is able to describe at least
reflection an event or situation in one event or situation in
which he was involved which he was involved and
and that relates to a that relates to a formulated
formulated learning learning outcome but
outcome. unable to distinguish
between the event
description and the
description of the personal
emotions involved.
3.2 Reflection on the Is not able to describe Is able to describe at least
internship an event or situation in one event or situation in
which he was involved which he was involved and
and that relates to a that relates to a formulated
formulated learning learning outcome but
outcome. unable to distinguish
between the event
description and the
description of the personal
emotions involved.
C. Presentation 30% weightage
D. Report 30% weightage Can be planned as per School and to be communicated by the CR Coordinator.
Mark for item
6 7
Is able to describe at least Is able to describe at least
one event or situation in one event or situation in
which he was involved and which he was involved and
that relates to a formulated that relates to a formulated
learning outcome, properly learning outcome, properly
distinguishing between the distinguishing between the
event description and the event description and the
personal emotions personal emotions
involved, but unable to involved, and able to
formulate personal points formulate personal points
of improvement and of improvement and
related actions in a future related actions in a future
situation situation
Is able to describe at least Is able to describe at least
one event or situation in one event or situation in
which he was involved and which he was involved and
that relates to a formulated that relates to a formulated
learning outcome, properly learning outcome, properly
distinguishing between the distinguishing between the
event description and the event description and the
personal emotions personal emotions
involved, but unable to involved, and able to
formulate personal points formulate personal points
of improvement and of improvement and
related actions in a future related actions in a future
situation situation
8 9-10
Is able to analyze
objectively most events or
situations in which he
was involved and that
relates to formulated
learning outcomes, derive
improvements for a future
situation and formulate
plan for improved
functioning in a new
situation. Shows the
ability in at least one case
to implement the
formulated plan for
improved functioning
Is able to analyze
objectively most events or
situations in which he
was involved and that
relates to formulated
learning outcomes, derive
improvements for a future
situation and formulate
plan for improved
functioning in a new
situation. Shows the
ability in at least one case
to implement the
formulated plan for
improved functioning
Is able to analyze
objectively any event or
situation in which he was
involved and that relates to
formulated learning
outcomes, derive
improvements for a future
situation and formulate
and implement a plan for
improved functioning in a
new situation.
Is able to analyze
objectively any event or
situation in which he was
involved and that relates to
formulated learning
outcomes, derive
improvements for a future
situation and formulate
and implement a plan for
improved functioning in a
new situation.
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 ANNEXURE VII : REPORT OF EVALUATION
to be submitted by School Deans to CoE
MIT Academy of Engineering

School of _______________________

Class : FY / SY / TY / B.Tech.

Date of Evaluation : ___________________

Roll No Name of student PRN Criteria A Criteria B Criteria C Criteria D TOTAL MARKS
30% 10% 30% 30%

Dean

School of _______________________

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 ANNEXURE – VIII
INTERNSHIP REPORT FORMAT

STUDENT INTERNSHIP PROGRAM (SIP)

REPORT

Name of the Institute / Industry

(Where you have completed your Internship Training)

(Bold, 16 font, Times New Roman style)

Submitted By

Name of the student

Exam Seat No.
PRN No.
 SCHOOL OF __________________________

MIT ACADEMY OF ENGINEERING

ALANDI (D), PUNE

CERTIFICATE

This is to certify that the “Student Internship Program (SIP)” report

submitted by _____________________ PRN _____________ is work done by
him/her and is submitted during _____________ academic year.

Faculty Mentor School - Internship Coordinator

(Name) (Name)

School Dean
(Name)
Internship certificate provided by the internship organization
ACKNOWLEDGEMENT

(Name of student)
 Table of Contents

Topic Page No.

1. Introduction

1.1 1

1.2

2. Internship Discussion

2.1

2.2

3. Conclusion

4. Bibliography
1) Introduction includes brief description of the Organization/ Institute. The starting and ending
dates of your internship. The scope of the work completed during the internship. It may include
background information necessary to understand the work completed during the internship.

2) Internship discussion should include report of the work carried out in Organization / Institute. It
may contain:

⮚ Problem / Project / Opportunity the student got in the Institute/ Organization.

⮚ Learning Experience should include:
a) Knowledge acquired: Briefly describe the knowledge you gained through
your training experience and relate this knowledge to what you learned in
specific courses.
b) Skills learned: Describe the skills and any career-specific abilities that you
gained during your internship.
c) Observed attitudes and gained values: Describe the manners, mindsets or
values that you found and you perceive as important, in your training program,
for a successful career (e.g. hard work, dependability, honesty, etc.)
d) The most challenging task performed: Describe the best and the most
challenging mission that was assigned to you during your internship, how you
performed it, and how you overcame challenges while performing it.
3) Conclusion: Summarize your overall experience in the internship keeping in mind the tasks
performed and your learning experience.

4) Bibliography: Provide all the sources that you have used for data collection /project execution/
report preparation (books, articles, reports).

5) Plagiarism Report: Attach a plagiarism report at the end of the report. (Acceptable range: 1-
20%)
1. Paper Size: A- 4 size paper. Each page should be numbered.

2. Margins:
1. Top : 1” (1 inch=2.54cm)
2. Bottom : 1.15” (2.86cm)
3. Left : 1.4”
4. Right : 0.6”

3. Line Spacing: 1.5 line

4. The report should be between 15-20 pages (exclusive of references, title pages, table of
contents) and spiral bonded with one side printing.
5. Use single in-space in footnotes (if required).
6. Standard formal level of English should be used.
7. Deadline for Final Submission of the report must be strictly adhered to.