(5) Sample Letter (with Checklist) for submission of documents

Date

Deputy Dean, Student Developmenty

<Name of Faculty>
<Faculty Address>
Universiti Tunku Abdul Rahman

Dear Sir

SUBMISSION OF DOCUMENTS FOR INDUSTRIAL TRAINING

I _ NRIC No_ _ _ Student ID No. __,

(to state student’s name)
pursuing a Course of Study: <Course Name>, <state Year & Semester> refer to the industrial training
from <date> to <date> given to me by the Company <to state the company name, company number
and address>

I hereby submit the following documents: (Put a  tick in the appropriate boxes)
 A copy of the Company’s letter of offer for industrial training
 Letter of Undertaking and Indemnity for the University given by the student
 Letter of Undertaking and Indemnity for the University given by the student’s parents/guardian
 Letter of Indemnity for the Company given by the student
 Letter of Indemnity for the Company given by the student’s parents/guardian
A Cover Note or Duplicate Copy of Insurance Policy for:
 Additional insurance coverage of Group Personal Accident Insurance
 Death [please specify limit of coverage RM ]
 Permanent Total Disablement [please specify limit of coverage RM ]
 Personal Liability Insurance [please specify limit of coverage RM ]
 Medical Insurance [please specify limit of coverage RM ]
 Hospitalization & Surgical Insurance [please specify limit of coverage RM ]
 Any other insurance policies as advised by the University
[please specify type(s) ……………………………….. and limit(s) of coverage RM ]
 Any other insurance policies as stipulated by the Company
[please specify type(s) ………………………………… and limit(s) of coverage RM ]

Thank you.

Yours sincerely

Student’s Signature
Name:
Contact Address:
Contact Phone Nos:

Enclosures: ( )

ACKNOWLEDGEMENT
I,.............................hereby acknowledge receipt of the above documents from the above named student

Industrial training Coordinator’s Signature:

Name of Coordinator:
(6) Sample Letter of Undertaking & Indemnity for UTAR Given By Student
Date: ………………………………….

Deputy Dean, Student Developmenty

<Name of Faculty>
<Faculty Address>
Universiti Tunku Abdul Rahman

Dear Sir

INDUSTRIAL TRAINING UNDERTAKING AND INDEMNITY

I, …………………………………………….. NRIC No …………………………………. Student ID No

……………………am pursuing a Course of Study ……………..……………………………………….
Year & Semester…………………….. refer to the industrial training as stated in the Letter of Offer by
the Company (hardcopy of the Letter of Offer shall be forwarded to Faculty).

I, hereby declare and agree to abide by the University’s terms and conditions for industrial training,
including but not limited to,:-

1) to further declare and confirm that the University shall not be held responsible in the event of
any misfortune or accidents and/or personal injuries whether fatal or otherwise involving me.

2) shall undertake full responsibility of all the consequences should any other person or body
suffer such accidents and/or personal injuries and/or damage to property as a result of my
negligent act or omission during the course of industrial training.

3) shall indemnify and keep indemnified the University against any liability, demand, claim, loss or
lawsuit in respect of personal injuries to me and/or to anybody and/or property damage arising
out of or caused by my negligent act or omission during the course of industrial training.

4) shall undertake to uphold the good name of the University and abide by the code of conduct of
the University, the Company, the industry and any other relevant rules and regulations at all
times during the course of my industrial training. I shall not hold the University responsible for
my misconduct or wrong doing at all times during the course of my industrial training.

5) to further undertake not to breach the terms and conditions of the contract for industrial training
between myself and the Company.

I hereby acknowledge and confirm that I have been cautioned to obtain additional insurance coverage
for the current Group Personal Accident (for students) Insurance and to obtain the necessary
insurance coverage for Medical, Hospitalization and Surgical and Personal Liability Insurance
coverage for any accidents or personal injuries or perils or losses or damage caused to persons or
body or property during the period of the industrial training.

I further declare that I shall obtain, maintain and keep these insurance polices valid throughout the
period of the industrial training.

Yours sincerely
Student’s Acceptance
(7) Sample Letter of Undertaking & Indemnity for UTAR Given By Parents/ Guardian

Date: …………………………………

Deputy Dean, Student Developmenty

<Name of Faculty>
<Faculty Address>
Universiti Tunku Abdul Rahman

Dear Sir

INDUSTRIAL TRAINING UNDERTAKING AND INDEMNITY

We,........................................................................................................................................ The
parents/guardian of
……………………………………..... refer to the industrial training as stated in the Letter of
Offer by the Company.

We, the undersigned parents/guardian shall ensure that our son/daughter shall abide by the
University’s terms and conditions for industrial training, including but not limited to, :-

1) hereby declare and confirm that the University shall not be held responsible in the event
of any misfortune or accidents and/or personal injuries whether fatal or otherwise
involving our son/daughter.

2) shall undertake full responsibility of all the consequences should any other person or
body suffer such accidents and/or personal injuries and/or damage to property as a
result of our son/daughter’s negligent act or omission during the course of industrial
training.

3) shall indemnify and keep indemnified the University against any liability, demand, claim,
loss or lawsuit in respect of personal injuries to our son/daughter and/or to anybody
and/or property damage arising out of or caused by our son/daughter’s negligent act or
omission during the course of industrial training.

4) shall ensure that our son/daughter uphold the good name of the University and abide
by the code of conduct of the University, the Company, the industry and any other
relevant rules and regulations at all times during the course of industrial training.

5) further confirm that the University shall not be held responsible for our son/daughter
misconduct or wrong doing at all times during the course of industrial training.

6) shall ensure that our son/daughter shall not breach the terms and conditions of the
contract for industrial training.

We, hereby acknowledge and confirm that we have been cautioned to obtain additional
insurance coverage for the current Group Personal Accident (for students) Insurance and to
obtain the necessary insurance coverage for Medical, Hospitalization and Surgical, and
Personal Liability Insurance coverage for any accidents or personal injuries or perils or losses
or damage caused to persons or body or property during the period of the industrial training.

We, the undersigned parents/guardian further declare that we shall obtain, maintain and keep
these insurance polices valid throughout the period of the industrial training.
Yours sincerely

………………………………....
Parents’/Guardian’s Signature
Name of Father: …………………………………………….
Name of Mother: ……………………………………………
Name of Guardian: …………………………………………
Contact Address:
……………………………………………………………………………………………
……………………………………………………………………………………………………………
……
Contact Phone No: …………………………………………
Enclosure: (Company’s offer letter)
(8) Sample Letter of Indemnity & Undertaking for the Company Given By Student

Date: …………………………….

Name & Designation: ……………………………………………………………..

Name of the Company: …………………………………………………………...

Address:
……………………………………………………………………………………………………...

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

Attention: …………………………………………………………………….…….

Dear Sir

LETTER OF INDEMNITY FOR INDUSTRIAL TRAINING

I, ....................................................................... NRIC No.........................................Student ID

No.

......................................Course of Study: .............................................................Year &

Semester:

...................................... Period of Industrial Training: From...................................to

…………………….
refer to the above industrial training given to me by your Company.

In consideration of your Company affording the above industrial training, I shall be liable for
and indemnify your Company against any liability, demand, claim, loss or lawsuit in respect of
personal injuries to me and/or to anybody and/or property damage arising out of or caused by
my negligent act or omission during the course of industrial training.

I shall undertake full responsibility of my action and behaviour at all times during the course of
industrial training. The University shall not be liable for my misconduct or wrong doing.

I confirm that I am currently a UTAR registered student, who is covered by Group Personal
Accident (for students) Insurance, as stipulated in the insurance policy.

I further undertake not to breach the terms and conditions of the Company’s contract for
industrial training.

Yours sincerely

Student’s Signature
Name: …………………………………………………………
Contact Address: ………………………………………………………………………………………
…………………………………………………………………………………………………………
Contact Phone No: ………………………………………….
Enclosure: (UTAR Group Personal Accident insurance)

cc: Deputy Dean, Student Development, Faculty of Accountancy and Management

Universiti Tunku Abdul Rahman, 43000 Kajang, Selangor
(9) Sample Letter of Indemnity & Undertaking for the Company Given
By Parents/Guardian

Date: …………………………….

Name & Designation: ……………………………………………………………..

Name of the Company: …………………………………………………………...

Address:
……………………………………………………………………………………………………...

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

Attention: …………………………………………………………………….…….

Dear Sir

LETTER OF INDEMNITY FOR INDUSTRIAL TRAINING

We,
…………………………………………..…………………………………………………………………….……...

the parents/guardian of
………………………………………………………………………………………………….

refer to the industrial training as stated in the Letter of Offer.

In consideration of your Company affording the above industrial training, we, the undersigned
parents/guardian shall be liable for and indemnify your Company against any liability, demand, claim,
loss or lawsuit in respect of personal injuries to our son/daughter and/or to anybody and/or property
damage arising out of or caused by our son/daughter’s negligent act or omission during the course of
industrial training.

We shall undertake full responsibility of our son/daughter’s action and behaviour at all times during the
course of industrial training. The University shall not be liable for our son/daughter’s misconduct or
wrong doing.

We confirm that our son / daughter, being a registered student, is currently covered by Group Personal
Accident (for students) Insurance, as stipulated in the insurance policy.

Yours sincerely
…………………………………………………
Parents’/Guardian’s Signatures
Name of Father: …………………………………………………………
Name of Mother: …………………………………………………………
Name of Guardian: ………………………………………………………
Contact/House Address:
………………………………………………………………………………………………...
…………………………………………………………………………………………………………………………
……
Contact Phone No: ……………………....
Enclosure: (UTAR Group Personal Accident insurance)
cc: Deputy Dean, Student Development, Faculty of Accountancy and Management
Universiti Tunku Abdul Rahman, 43000 Kajang, Selangor
(11) Application Form

INDUSTRIAL TRAINING
(To submit in duplicate)

Period for Industrial Training: / _/_ to _ /_ _/

Trainee particulars:

Name: Sex :__ _

(In full & Block letters)
Registration No. : _ I.C.:
Faculty: _ Course: _ _Year of study:__ Semester: _
Correspondence Address: _
_ Post code: _ _
Telephone/Mobile Phone no. : Email Address: _ _

Name of Company assigned: _ _

Address: _
_
Telephone No. : Fax No. : _ Email Address: _ _
Contact Person : _Designation:_ _
Type of Business/Work function : _ _

Name of supervisor assigned by UTAR: _

Email Address:

Declaration

I declare that
1. I fully understand and abide by the terms & conditions stated in the UTAR Industrial Training Manual;
2. I am not working at my close relative’s company to avoid conflict of interest during the training; and
3. I may be subject to disciplinary action should I infringe any stipulated rule and regulation during the
period of training.

_ _ _ _
(Signature) (Date)
(12) Contact form

INDUSTRIAL TRAINING

Importance Contact Particulars

Trainee particulars:

Name: Registration No.

:_
(In full & Block letters)
Faculty: _ Course: Year of
Study:_ _Semester: _

Current Address:
_ __
_ Post code: _
Telephone/Mobile Phone
no. : Email Address:
_ _

Name UTAR supervisor:

_
Hand phone No. : Fax No. : _ Email Address: -
_ _

Name of Company assigned:

_ _
Address:
_

Name of Manager:
_ _
Telephone No. : Fax No. : _ Email Address:
_
Name of Co. Supervisor:
_

Telephone No. : _ _ Fax No. :_ Email Address: