Industrial Training Placement Form.docx

PK.FKK.PPLI.TAWARAN (1)

INDUSTRIAL TRAINING PLACEMENT FORM Reference No.

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Date

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Hawaiah binti Imam Maarof @ L.Maarof Industrial Training Coordinator Faculty Of Chemical Engineering

Fax: 03-5543 6300 [email protected] [email protected]

Universiti Teknologi MARA 40450 Shah Alam, Selangor Darul Ehsan

We hereby AGREE / DISAGREE* to accept your student to undergo the industrial training in our company within the period of until . The particulars of the arrangement are as follows: Student’s name Program

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NOOR ALIYA BINTI MUHAMMAD KAMAL EH220 / EH243

Company name

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Company address

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Supervisor’s name

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Department

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Monthly allowance (if any)

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Offer valid until

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Please indicate the job roles/responsibilities of this trainee in your organization (compulsory to fill): …………………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………… Thank you. Yours faithfully ……………………………………………… (Signature) Name: ........................................................................................ Position: ....................................................................................

Important Note: Student to fill in COORDINATOR AND STUDENT PARTICULARS ONLY. Tick the respective email address and program box before attach this form in application.

Contact no.: .............................................................................. * Please cross the inapplicable ** Final date in which the student must send official notification to the company / organization confirming placement. In the event that no notification is sent, the above offer automatically becomes null and void.

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