Practical Training Declaration Form

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DECLARATION / UNDERTAKING
FROM THE STUDENT FOR PRACTICAL TRAINING
I, Mr. /Ms.………………………………………......................................................................................................,
Son of Mr. ……………………………………………………………………..……………………………………….. and student of JIFSA
Education and Technical Services Pvt. Ltd., Franchisee Branch …………………………………………………… Under
Program …………..…………………………………………………….………………………………………………………………..…………………
Permanent resident of ….............…………….....................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
Height ………….. cm Shoes size.……….…(7 to 11) Vest Size .………… (28 to 38) Shirt Size …………. M to XXL
Attending Practical Training from …………………………………………….…... to ………………………………………………………
My Parents Contact no. ……………………………..……………. & My Mobile No: ............................................., do
hereby declare and undertake on this the …………… (Date), of …………............ (Month)................. (Year), the
following:-
 I, hereby, declare that, the entries completed by me in the Application Form are true to the best of my
knowledge and based on records.
 I, hereby, undertake to present the original government issued documents like, Aadhaar Card, Driving
Licensee, Voter card, Pan Card or Passport, immediately upon demand by the concerned authorities of
the academy as well as submit a photocopy of the document.
 I, herby, accept that Institute is not responsible for any kind of unfortunate incident with me like, snake
bite, insect bite, and any kind of incident or accidents during training or outside of campus.
 I, herby, accept that during Practical training in company as well as outside of the campus, I will be sole
responsible for any kind of injury, illness, and medical unfit and bear all the medical expenses.
 I, hereby, promise to attendant the complete training program provided by the Institute without failure,
if I fails to attendant or missed the training program, than institute may take any step or legal way for
the conduct.
 I, hereby, promise to abide by the admissible rules and regulations, concerning discipline, attendance,
etc. of the Institute JIFSA Education and Technical Services Pvt. Ltd., regarding practical training and also
to follow the Code of conduct prescribed for the Students of the Institute, as in force from time to time
and subsequent changes/modifications/amendment made thereto. I acknowledge that, the Institute
has the authority for taking punitive actions against me for violation and/or non-compliance of the
same.
DECLARATION / UNDERTAKING FORM Page 1 of 2

 I, hereby, undertake to be present in the college/training campus dress code along with safety shoes
and Institute ID card during the practical training and in industrial visit, without id card I should not be
permitted.
 I, hereby declare that, I will neither join in any coercive agitation/strike for the purpose of forcing the
authorities of the Institute to solve any problem, nor I will participate in any activity which has a
tendency to disturb the peace and tranquility of life of the JIFSA training campus and/or its Hostel
premises.
 I, hereby declare that, I shall be solely responsible for my involvement in any kind of undesirable / in
disciplinary activities outside the campus, and shall be liable for punishment as per the law of the land.
I, further understand that, the Institute shall in no way provide any support to me and will not be held
responsible for my any such action during the practical training and in industrial visit.
 I, hereby declare that, I shall be solely responsible for any kind of accident / fatality / illness during on or
off the practical training or in industrial visit.
 I, also declare that, I am not suffering from any serious/contagious ailment and/or any psychiatric /
psychological disorder.
 I, further declare that, if for the industrial visit, I will fulfill the required documents, Bond and
undertaking which are essentials of industry and practical training by my own expenses (bearing the
complete expenses).
 I, further declare that, my industrial visit and practical training, may be cancelled, at any stage, if I am
found ineligible/misbehaved/irregular and/or the information provided by me are found to be incorrect.
 I, hereby undertake to inform the Institute, about any changes in information submitted by me, in the
Application Form and any other documents, including change in addresses and phone nos., from time to
time.
 I, herby, accept that Industrial visit program is not the part of course syllabus, it has been provided as
additional facility to us by the institute.
 I, herby, accept that Institute is not responsible for the visiting duration provided for the Industrial visit,
as it is under the availability of Industrial visit schedule and norms of Industries or companies.
 I, herby, accept that Institute may provide Industrial visit program in anywhere location within
Chhattisgarh as per availability of visit by Industries or companies, private or govt. any.
 I, hereby declare that, I shall be solely responsible for any kind of accident / fatality / illness during
travelling towards from/to the practical training or in industrial visit.
Date: Signature of Student

Day: Name in Block Letters
Place:
Verified by: Training Head ………………………………….. Principal Signature: …………………………………..
DECLARATION / UNDERTAKING FORM Page 2 of 2

Practical Training Declaration Form

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DECLARATION / UNDERTAKING FORM Page 1 of 2

Date: Signature of Student

Verified by: Training Head ………………………………….. Principal Signature: …………………………………..

DECLARATION / UNDERTAKING FORM Page 2 of 2

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