Name :
College/University :
Degree/Discipline :
Guide in IITB :
Dept. in IITB :
Topic/Title :
Duration (from-to) :

( I understand that IPR rules will be as per IIT Bombay's rules)

Student's signature

(Signature of Student's college Principle ) (Signature Head of Dept. at IITB) ( Guide's signature)

Students should submit the form alongwith 3 passport size photographs in Academic Office after obtaining the signature of Principal of college,Guide and Head of Department.

Approved/not approved
Dean (AP), IITB

To : Cash Section
Kindly collect External Student fee of Rs.
Dy.Registrar (Acad.)

To : IITB Security
Please issue temporary Identity Card to the student valid until

Dy.Registrar (Acad.)

To : Central Library
Please issue temporary Card for reading room facility to the student valid until

Dy.Registrar (Acad.)

To : Academic Office

The student has done satisfactory work. HE may be issued a certificate of project work.


Date :