For Group A

Application for Internship 2016-17(Group A)

To,

Affix passport size

photo duly attested
by Head of
Institution/Deptt./

The Director,
Training Division, Central Statistics Office,
Ministry of Statistics and Programme Implementation,
Room No. 22, 9thFloor, J.P.Building,
25-K.G.Marg, New Delhi 110001

Gazetted Officer

Madam/Sir,
My application for internship may kindly be considered. The details of my Bio-Data are as follows:
Sl
1.
2.
3.
4.

b).

Name (in Capital letters)

Father/Husbands Name
Date of Birth
Sex (Female/Male)
Postal address

SANDEEP SINGH
KHEM SINGH
02/07/1994
MALE
DS-19, Madras School of Economics, Ranjith Road, Kotturpuram,
Chennai- 60025
KHSND45@GMAIL.COM
7358630170
Graduation
Post-Graduation
Research
work
(M.Phil, PhD)
B.COM(Hons.)
M.Sc.(Economics)
Accounting, Finance and
Taxation

E-mail (Must be given)

Mobile

5.

Educational Qualifications

Subjects

b
c

Year of Passing
Name and address of the College

Name of University

Maximum Marks in examination

2700
(Enclose Copy of the Graduation Mark
sheet- all three years)
Total Marks obtained
1908
Marks obtained excluding qualifying papers 1792/2500
% of marks(excluding qualifying papers)
71.68
Division/Grade
Ist
st
2nd
Preference of office/subject codes as per 1
Annex-I

f
6.

2014
Acharya Narendra Dev
College, Govindpuri,
Kalkaji, New Delhi

Appearing
Madras School of
Economics,
Kottupuram,
Chennai
Central University
of Tamilnadu
Appearing

University of Delhi

th

th

3 4th

5 6th

rd

th
th

9 10
th

1 12th
1
th

7.

Signature of the Student with date

8.

No objection form Head of the Institution/Department

Certifiedthat Ms./Mr. SANDEEP SINGH is a 1 st year post-graduate student/ research scholar of the Deptt./Institute
Madras School of Economics, of Central University of Tamilnadu. This Department /Institute / Collage have no
objection if he/she undergoes internship under the Internship Scheme 2016-17 of MoSPI.

Signature with date& seal_________________

Name___________________________(_Seal)

Application for Internship2016-17 (Group B) For Group B

To

Affix passport size

photo duly attested
by Head of
Institution/Deptt./
Gazetted Officer

---------------------------------------------------------------------------------------------Madam/Sir,

My application for internship may kindly be considered.The details of my Bio-Data are as follows:
Sl
1.
2.
3.
4.
b).
d).

Name (in Capital letters)

Father/Husbands Name
Date of Birth(dd/mm/yyyy)
Sex (Female/Male)
Postal address
E-mail(Must be given)
Contact Telephone No
Mobile

5.

Educational Qualifications

Subjects

b
c

Year of Passing
Name and address of the College/University

Name of University

Maximum Marks in examination

Graduation PostResearch
work
Graduation (M.Phil, PhD)

(Enclose Copy of the Graduation Mark sheet- all three years)

f
6.

7.
8.

Total Marks obtained

Marks obtained excluding qualifying papers
% of marks(excluding qualifying papers)
Division/Grade
Preference of internship Centre (please entre office code 1st
from available options under respective selection points 4th
as per Annex - II)
Signature of the Student with date

2nd

3rd

5th

6th

No objection form Head of the Institution/Department

Certifiedthat Ms./Mr. _____________________________is a ____ year post-graduate student/
research scholar of the Deptt./Institute/Collage ________________________, of University of
______________________________. This Department /Institute / Collage have no objection if he/she
undergoes internship under the Internship Scheme 2016-17 of MoSPI.

Signature with date& seal_________________

Name___________________________(_Seal)