G H RAISONI COLLEGE OF ENGINEERING

(An Autonomous Institute affiliated to Rashtrasant Tukdoji Maharaj Nagpur University, Nagpur)

Accredited by NAAC with ‘A’ Grade

CRPF Gate No. 3, Hingna Road, Digdoh Hills, Nagpur – 440 016. (INDIA)

Phone :, 9604787184, 9689903286, 9921008391 Fax : +91 – 7104 – 232560

E-mail : Web : ghrce.raisoni.net

Application Form for Student

(Internship/Training/ Paper presentation / Publication registration fee/ Project Competition /Final Yr. Project/Innovation contest, any other )

To Date: ………………..

Dean (Industry Relations)

G. H. Raisoni College of Engineering, Nagpur

Through: Head of Dept of …………………………………….

Res. Sir/Madam,

Kindly consider my application of financial assistance for ( √ whichever is applicable)

[Internship/Training/ Paper presentation / Publication registration fee/ Project Competition /Final Yr. Project/Innovation contest, any other]

I am attaching following documents.

1)  Budget / statement of expenses(given below format table 1)

2)  Copy of permission/invitation letter from the industry/institute/organizers

3)  Leaflet/Information Brochure of training program / Project competition / Acceptance letter, Full length Paper & Reviewer’s Remarks/Comments

4)  Application in AICTE/ DST format (for Int. conf. abroad) with Quotation (Air fare for Int. Conf. abroad) (Original)

5)  Statement (To be submitted after the event) from organizer that the expenses (TA & DA) not supported/partially provided.

6)  For claim for travel concession submit all original bills, Tickets

7)  Certificate of participation / completion Internship/Training/ Project Competition / Paper presentation

You are requested to kindly accord approval for the same.

Thanking You,

Sincerely,

Signature of Student

Name of student / Class/Sem. / Branch / Mobile No. / Email

Total fund availed in this academic session: Rs......

Recommendation:-

Signature & Name of HOD

------

Submitted to Principal:

FORMAT for Submission of Proposal Amount in Rs.
Academic session
Name of student/s
Name of Guide
Department
Section/Class
Title of project
Abstract in 200 Words
Capital cost required (Enclose detailed list with cost)
Consumables(Enclose detailed list with cost)
Testing charges (Enclose detailed list with cost)
Cost of old equipment to be used
Sponsorship availed
Registration fee (if any, enclose leaflet)
Transportation cost
TA/DA ( Enclose details)
Total Amount

UNDERTAKING

In my own interest, I am willing to participate in______(Details of Event Organization/Address) during ______(dates). I hereby give an undertaking as under.

·  I am fully aware that no faculty coordinator is accompanying me and no coordinator is appointed on behalf of college at the place of event.

·  I shall be responsible for my conduct and own safety and G. H. Raisoni College of Engineering, Nagpur shall not be responsible for this in any manner.

·  I shall not make any claim and no type of any claim shall be made in my respect and on my behalf by anyone in respect of any loss or injury to me (including fatal injury or death) or to the property of mine, which may suffer or occur during the abovementioned event.

·  I will not act in any manner, which defames the college in any manner whatsoever.

Date: Signature:

I have allowed my ward (name as indicated above) for the abovementioned event and instructed him/her to take due precaution for safety and discipline. I also undertake that the Institute/ College shall in no way be responsible for any loss or injury to my ward during the programme.

Date: Signature:

Place: Name of Parent:

Address: Phone Number: