IESL COLLEGE OF ENGINEERING

Industrial Training for Engineering Advanced Diploma Students

Student Request for Exemptions in Industrial Training Module – (Annex – J)

 The applicant should read and understand the ‘Training guidelines for undergraduates’
before filling this form, and ensure that he/she has satisfied all pre-requisites for Industrial
Training prior to submit the request form.

 ‘Industrial training exemption request’duly prepared according to the template given

below should be submitted to the Training Engineer, IESL College of Engineering,
120/15, WijeramaMawatha, Colombo 7 on or before 28 February 2014.

1. Personal details of the Applicant:

1.1 Name as in the Student I/D : (Mr. /Ms) …………………………………………………………………………………………

1.2 Permanent address: …………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………

1.3 Postal address if different from above: …………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………

1.3 E mail address: …………………………………………

1.4 Telephone number: (Residence) ………………………………… (Mobile) ……………………………

1.5 Student I/D No. ……..………………………….. National Identity card number: ……………………………….

1.6 Field of study in the College of Engineering : ………………………………………………..

1.7 Subject code for which exemption is requested: …………………………

2. Details of Engineering/ Technical Study Programmes followed by the applicant previously:

(If the applicant has completed more than one study programme in the past which included industrial training, indicate
the details for each study programme separately.)

2.1 Name of the Study programme: ………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………..
2.2 Address of the educational institution, which conducted the study programme in 2.1: ………………
……………….…………………………………………………………………………………………………………………………………………..

2.3 Field of study: …………………………………………………………………………………….

2.4 Date on which the qualification from the above study programme awarded.:………………………….

2.5 Nature of the Programme: Full Time or Part Time

2.6 List Subjects / course modules completed in each level and results below:

2.7. State the Field of industrial training component of the course relevant to 2.1 to 2.6:
………………………….. …………………………………………………………

2.7.1 Name and Address of the training provider to the education institution in 2.2: …………………..
………………………………………………………………………………………………………………………………………………

2.7.2 Contact details of the work site/work place/workshop with the designation of the person to be
contacted if necessary: …………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………….

2.7.2 Period of training under the above study programme: …………………………………………………………….

2.7.3 Details of Training undertaken / Work carried out in the training place identified in 2.7.1
(comprehensive details should be given below):

2.7.5 State whether the applicant enclosed with this request the following documents:

Daily diary
Yes No

Training Report: Yes No

 Training Certificate issued by NAITA: Yes No

3. Employment record:
(If employment is in more than one place, indicate details relevant to eachemployer separately and in
the chronological order)

3.1 Name and address of the employer:

3.2 Name, designation and contact details of the Supervising Engineer/Officer-in-charge / Contact
person who supervised the work:

3.3 Positions held at the above place by with relevant dates to the post:

3.4 Employment details with places, projects and dates if any:

3.5 Work experiences (actual work handled by the applicant) should be given comprehensively):

3.6 The period of training and work experience in which the applicant claims:

4. Declaration:

I declare by signing below that the information submitted by me above are true and correct to best of
my knowledge, the training reports and daily diaries are the originals prepared by me, photocopies of
documents enclosed are copies of original documents and I am prepared to submit any other
information required for assessment of my training and work experience given above whenever the
Training Engineer of the IESL College of Engineering requested me to do so. (All photocopies shall be
signed by the applicant and originals shall be submitted with the photocopies for verification.)
Signature of the Applicant: Date of Submission: ……………………..

Name: