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Internship 09 Nov 2023

The document provides an application form for an internship program with Madhya Pradesh Rajya NITI Aayog. The form requests applicant details like name, education qualifications, work experience, area of interest, expected duration and dates. It also provides instructions for filling and submitting the application form along with necessary declarations.

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49 views4 pages

Internship 09 Nov 2023

The document provides an application form for an internship program with Madhya Pradesh Rajya NITI Aayog. The form requests applicant details like name, education qualifications, work experience, area of interest, expected duration and dates. It also provides instructions for filling and submitting the application form along with necessary declarations.

Uploaded by

ajs1883
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Madhya Pradesh Rajya NITI Aayog

1st Floor, ‘C’ Wing, Vindhyachal Bhawan, Bhopal


Ph. No.: 0755-2551135; Fax No.: 0755-2772074; Email: [email protected]

Application form for Internship Programme

1 Name

2 Institution (Studying/has studied in)

3 Details of course of Study with its


duration
4 Internship duration sought (in months)

5 Proposed earliest date of joining

6 Address for correspondence Address Line 1-


Address Line 2-
City
State
Pin code
Mobile No.
E-Mail
7 Date of Birth (DD/MM/YY)

8 Area of interest/ learning 1 Administration & Coordination


(Tick the Appropriate- Max 3)
2 SDG, Aspirational Districts &
Aspirational Blocks
3 Knowledge Management, Science
& technology Innovation
4 Agriculture & Allied Sector

5 Education & Skill Development

6 Tourism

7 Health & Wellness

8 Economics and Finance

9 Industrial Development

10 Infrastructure Development

11 Social Development
9 Educational Qualifications (Starting from Class 12th onwards)
Name of Name of Exam Year Percentage/ Main Subjects
Board/University/ Institute Passed CGPA
9.1

9.2

9.3

9.4

9.5

10 Work Experience details, if any


Name of Employer Work Work Domain
Experience
(in Months)
10.1

10.2

10.3

10.4

11 Is the internship request related to present course of


study? If so, please specify (for candidates who are
presently perusing studies)

12 Names of two References with designation & S.N. Particulars Details


communication details, including mobile number and
email address. 1 Name:
(for an applicant who have passed out during last 3 2 Designation:
years, one of the references has to be from a faculty
of his/her immediate past institute of learning) 3 Address

4 E-mail:

5 Mobile
Number:
S.N. Particulars Details
1 Name:

2 Designation:

3 Address

4 E-mail:

5 Mobile
Number:
13 If selected as an intern, please mention your
expectations from the Internship opportunity at
MP_SPPC
14 Are you willing to undertake field studies covering
remote areas of the state of Madhya Pradesh

Undertaking/ Declaration by the Applicant


I have read the guidelines/terms and conditions of the internship programme and I agree to abide and
follow them.

(Signature of the applicant)

For candidates pursuing studies at an educational institution/university

The applicant is pursuing his Graduate/Post-Graduate/Ph.D./other degree


Programme from our institute since ........(Date) and would be completing the same by ......... (Date)
The application is forwarded.

Place:
Date:
Signature name and seal** of the
Director/Dean/
HOD

For candidates who have passed out during 2017 and 2018*
The applicant has successfully completed his degree/post-graduate
programme at the Institute in……….. and has been found eligible for the award of………..
The application is forwarded.
Place:
Date:
Signature name and seal** of the
Director/Placement Coordinator/ Faculty
writing a reference

(* For the pass out candidate a separate write up can be enclosed and attached)
(** Printed letterhead can also be used)
Instructions Regarding Filling and Submission of the Form

1. Download the application form, fill it completely.


2. Declarations and undertaking are duly signed along with the seal of the signee, wherever
applicable
3. Make a single PDF file containing form and all the relevant documents, marksheets etc. The
hard copy of the PDF should be sent to the below address: -

Advisor
Madhya Pradesh Rajya NITI Aayog
1st Floor, ‘C’ Wing, Vindhyachal Bhawan, Bhopal
Ph. No.: 0755-2551135; Fax No.: 0755-2772074; Email: [email protected]

Note: “INTERNSHIP PROGRAM” should be written at the top of the envelope containing your
application.

4. The PDF should also be emailed to the email address:[email protected], the subject line of email
should be – <Internship Program> <your name>
5. Applicant will be informed through the email or call regarding acceptance of his/her application.
If required prior to the selection for internship applicant may be called for an interview (online or
offline).
6. If any other instruction is required to be given to the applicants will be informed through email.

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