Form : FET/TRG/02

FACULTY OF ENGINEERING TECHNOLOGY

OPEN UNIVERSITY OF SRI LANKA

INDUSTRIAL TRAINING COMPLETION FORM

(To be duly filled by the student, get properly certified by the Engineer / Officer-in-charge of training
and handed over to the Training Engineer strictly within 3 weeks from the last date of the training)

01 Name of Trainee :- *Mr./Ms.

(NB : *Delete what is NOT applicable)

02 Reg. No.: 03 NIC. No.:

04 Contact details used during the training period :

i.) Postal Address : -------------------------------------------------------------------------------------------------------------------------------

ii.) Tel. Nos.: Residence : -------------------------------------------------- Mobile : ------------------------------------------------
iii.) Email Address/es+ : -------------------------------------------------------------------------------------------------------------------------
(NB : + Write clear simple letters/digits/characters)

05 Field of Specialisation* : / Elect. & Comm. / Electrical / Computer / Mechatronics / Mechanical / BSE/
(NB : *Underline what is applicable) / Civil / Agriculture / Apparel / Fashion / Textile Manufacture / Text. Eng. /

06 Industrial Training Module* : / Electronics / Communication / Software / Power / Agri.–I / Agri.–II /

(NB : *Underline what is applicable) / Civil–Diploma / Civil–Undergrad: / Mechanical –I \ Mechanical –II /
/ Apparel – I / Apparel – II / Mechatronics – I / Mechatronics – II /
/ Fashion –I / Fashion Design & Product Dev. / Knitting / Weaving /
/ Yarn Manufacture / Agri. Eng.–I / Agri. Eng.–II / Chem. Processing/

07 Period of Training : From : / / To : / /

08 Details of the Training Establishment :

i.) Name of Establishment : ---------------------------------------------------------------------------------------------------------------

ii.) Postal Address : -------------------------------------------------------------------------------------------------------------------------------
iii.) Tel. Nos.: --------------------------------------------------------------------------------------------------------------------------------------------
iv.) Name of Officer-in-Charge of Trainee : -----------------------------------------------------------------------------------

v.) Phone No. of Officer-in-Charge : ------------------------------------------------------------------------------------------------

09 Comments of Engineer / Training Officer-in-charge of Trainee :

i.) Attendance* : Working Days (NB : *Indicate the number in the cages)
ii.) No. of days of Leave* :
(NB : * Indicate the numbers in the cages)
Authorised Unauthorised

iii.) Special Remarks if any :

10 Name, Signature and the Official Seal of the Engineer / Officer-in-Charge of Trainee :

Official Seal :
Name : ------------------------------------------------------------

Signature : ------------------------------------------------------------

Date : / /