Internship Form

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{company_phone}}

Email: {{company_email}}

Website: {{company_website}}

Internship Application Form

**Internship Position Applied For:** {{internship_position}}

**Department:** {{department}}

**Application Date:** {{application_date}}

Intern Personal Details

**Full Name:** {{intern_full_name}}

**Date of Birth:** {{intern_dob}}

**Nationality:** {{intern_nationality}}

**Identification Document Type & Number (e.g., National ID, Passport):** {{intern_id_type_number}}

**Residential Address:** {{intern_address}}

**Contact Number:** {{intern_phone}}

**Email Address:** {{intern_email}}

Educational Background

**Name of Educational Institution:** {{institution_name}}

**Qualification Pursued/Obtained:** {{qualification_name}}

**Major/Specialisation:** {{major_specialisation}}

**Start Date:** {{education_start_date}}

**End Date (or Expected):** {{education_end_date}}

**Relevant Coursework/Modules:** {{relevant_coursework}}

**Academic Achievements/Awards:** {{academic_achievements}}

Internship Details

**Start Date of Internship:** {{internship_start_date}}

**End Date of Internship:** {{internship_end_date}}

**Duration of Internship:** {{internship_duration}}

**Working Hours:** {{working_hours_per_day}} hours per day, {{working_days_per_week}} days per week ({{total_hours_per_week}} hours total).

**Stipend/Allowance (if any):** {{stipend_amount}} {{currency}} per {{stipend_period}}

**Supervisor Name:** {{supervisor_name}}

**Key Responsibilities & Learning Objectives:** {{key_responsibilities_learning_objectives}}

Emergency Contact Information

**Full Name:** {{emergency_contact_name}}

**Relationship to Intern:** {{emergency_contact_relationship}}

**Contact Number:** {{emergency_contact_phone}}

**Email Address:** {{emergency_contact_email}}

Declaration by Intern

I, {{intern_full_name}}, declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may lead to the termination of my internship.

I agree to abide by the company's policies and procedures throughout the duration of my internship.

**Date:** {{declaration_date}}

**Signature of Intern:** _________________________

Company Approval

**Approved By (Name):** {{approver_name}}

**Title:** {{approver_title}}

**Date of Approval:** {{approval_date}}

**Signature of Approver:** _________________________

Signature Block

_________________________

**Intern's Full Name:** {{intern_full_name}}

**Date:** {{date}}

_________________________

**For and on behalf of {{company_name}}**

**Name:** {{company_representative_name}}

**Title:** {{company_representative_title}}

**Date:** {{date}}