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Application for Internship at MDN

Student Name
Course Name
Branch Name
College/University
Present Address
Permanent Address
E-MAIL ID
Phone Number
Mobile Number
At what speed can you type (in WPM)

Are you capable of performing soldering tasks	Yes   No
Do you smoke or drink?	Yes   No
Do you consume alcohol?	Yes   No
Have you indulged in software piracy?	Yes   No

Please give details of a faculty member willing to recommend you and personally vouch for your behavior

	Faculty Name:
	Faculty Phone:
	Faculty Email

How many hours/week will you be at MDN during the semester (excluding sessionals/final)?	(hours/week)
How many hours/week will you be at MDN during the break (excluding 2 weeks off to visit family)?	(hours/week)
Where do you plan to do your final semester Practice School?	MDN  Other
If Other, give details
CGPA Marks:

1st Semester:		2nd Semester:
3rd Semester:		4th Semester:
5th Semester:		6th Semester:
7th Semester:
Technical Projects Done:

What:
Where:
When:
From:
To:

Awards:

Extra curricular Activities:
Other Training:
Do you intend to attend any other club, training, etc. during your internship at MDN?	Yes   No
If yes, give details
Are you planning on doing an internship at MDN through IAESTE?	Yes  No
Are you planning on doing an internship abroad?	Yes  No

Security Code:

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