Sample Template for the Internship Report
GS204 Internship with Industry
Internship Report
Computer Science Program
Name (NIM):
Company Name:
Main Telephone Number:
Mailing Address:
Telephone Number:
Start Date for Internship:
End Date for Internship:
Report Date:
Bina Nusantara International
Sample Template for the Internship Report
Disclosure Page
I hereby state and verify by my signature that I have reviewed this internship report. I
hereby affirmed that the report contains the actual project or assignment that I (or the
company I work for) assigned to this intern.
SUPERVISOR (Print Name): _______________________________________
DATE: ___________________
SIGNED: ___________________
Sample Template for the Internship Report
Abstract (one paragraph)
Describe where your internship was carried out (company, department, location, etc.).
Summarize your internship goals, activities, and accomplishments. In addition, describe the
key learning’s you took away from your internship. These should be both technical and nontechnical (for example, you might describe such things as how your organization was
structured, how individuals worked together in your company, how technical employees
interacted with customers, what company initiatives you observed, etc.)
Marked by,
Acknowledged by,
[Name of Head of School]
School of [Faculty Name]
Bina Nusantara International
Andreas U. Kuswara, ST, SKom., MM., Com.(IS)
Program Development Manager
Bina Nusantara International