Temporary Affiliation Application for AY 2013-14

8/13/2019 Temporary Affiliation Application for AY 2013-14

1/17

FORM AA9E01

APPLICATION FORM FOR THE COLLEGES SEEKINGTEMPORARYAFFILIATION

(For Existing Institution with or without increase/reduction in courses/intake)

of Degree level cour e !" E"g!"eer!"g#Tec$"olog%#P$&r'&c%I"clu(!"g E)! *!"g &"( "e+ PG cour e !" M,Tec$#M,P$&r'#M-A# MCA,

AICTE Per'&"e"* A..l!c&*!o" I,D No,

AICTE Curre"* A..l!c&*!o" No, / 01 2134

1, N&'e 5 A((re of *$e College 1&, 6NT7A College Co(e 8

Name inShort and

in fullform

Phones with

STD

Full Postalddress FaxPin code E!mail

, I"for'&*!o" o" E *& l! $'e"* of *$e I" *!*u*!o"a" #ear of starting of the Institution $

%" Date on which first a&&ro'al was accorded % the I TE/P I $c" Date on which first affiliation was accorded % the *NT+/*NT+ $

d" Date on which the State ,o'ernment &ermitted 'ariations $ e" -hether the institutions status is ,eneral/ .inorit / -omen $

, De*&!l of A..l!c&*!o"#I" .ec*!o" fee re'!**&"ce for 01 213 Details of fee Drawee

(on whom)Drawee ank DD No"/ Dated mount (0s")

&&l" Proces"and Ins&e" Fee1ostelrecognition fee

&, De*&!l of Aff!l!&*!o" fee re'!**&"ce for *$e .& * %e&r

cademicear

Details of fee Drawee(on whom)

Draweeank

DD No"/ Dated

mount (0s")

01 21 &&l" Proces" 2 Ins&e" Fee01 21 ffiliation fee01121 &&l" Proces" 2 Ins&e" Fee01121 ffiliation fee010211 &&l" Proces" 2 Ins&e" Fee010211 ffiliation fee009210 &&l" Proces" 2 Ins&e" Fee009210 ffiliation fee

(Please &ro'ide details in the a%o'e ta%le without fail)

3


2/17

3, De*&!l of *$e He&( of *$e I" *!*u*!o" /Pr!"c!.&l48

Name in shortand full form

ge 2D"4" "Phones

withSTDode

(5)

(0)(P)(.)

Designation1ighest6ualificationFull details

Fax

Date of Takingcharge

E!mail

Em&lo ment Immediatel %efore &resent assignment

:, N&'e 5 A((re of *$e Soc!e*%

Name inShort andin fullform

PhoneswithSTDode

(5)(0)(P)(.)

Full Postalddress FaxPin code E!mail

;, N&'e 5 &((re of *$e '&!" co"*&c* .er o" of *$e Soc!e*% < ( hair&erson/ orres&ondent/ Secretar )

Name Phoneswith STDdesignation

Educational6ualifications

Fax

ddress withPin ode

E!mail

=, De*&!l of o*$er &c*!v!*!e of *$e Soc!e*%#*ru *In and ad7acent to the8and allocated for thecollege

In the same 'illage9.unici&alit etcElse where

:


3/17

>, L&"( &"( -u!l(!"g (e*&!l of *$e College

a" 8and 8ocation $ (0ural/.unici&alit /.unici&al or&n" 8imits/ .etro&olitan it )

%" Total rea of land (in acres)$ (.ade a'aila%le exclusi'el for the Institution without an other structures9 utilities)

c" 0ough sketch of sha&e of the land with a&&roach road( From the Sur'e Field ma&s)

d" Title deed details of the 8and held % the societ and allocated for the college

S" No"

Doc" No" and Date 0e'" Di'"!S"0"D and Sur'e No" rea in cres

9, -u!l* u. &re&S"

No"Particulars 'aila%le

rea(s;"m)0emarks "G"

Ne+ Progr&''e &..l!e(83:=

Total

G


6/17

1 / 4, DETAILS OF PASSED O7T ST7DENT /El!g! le *o rece!ve (egree4

-,Tec$ # -,P$&r' # P$&r',D (ur!"g *$e &c&(e'!c %e&r 01121

S,No, F&cul*% /De.*, @! e4 A..rove( I"*&?e Ac*u&l I"*&?e P& e( !"D! *!"c*!o" 1 * Cl& "( Cl& P& Cl&

M,Tec$ # M,P$&r' # M-A # P$&r',D /P,-4 (ur!"g *$e &c&(e'!c %e&r 01121


MCA (ur!"g for *$e &c&(e'!c %e&r 01121


H


7/17

1 , Co" ol!(&*e( De*&!l of Full T!'e Te&c$!"g S*&ff S*re"g*$

Total num%er of students9 as &er sanctioned strength9 in all courses %eing offered % theDe&artment (Exam&le a De&t" ma offer a "Tech" and an ."Tech" course)

13, De*&!l of L& or&*or!e /+!*$ No, of E).er!'e"* &"( floor &re& !" ,',4

S" No

Name of the la%orator Floorarea(s;"m)

No" of workingom&uters withaudio9 software

ourses for which the la%" isto %e used and No" of studentsworking/&er week

3" English 8anguageommunication Skills

:" om&uter la%s=" Drawing 1all No" of Drg" Ta%les$

S"

No"

Name of the

la%orator

Floor

area(s;"m")

Ex&eriments ourses for which the la%" is

to %e used and No" ofstudents working/&er week Total No"

No" &erc cle! session

(8ist the a%o'e details for all the la%oratories of all de&artments)

S" No" Name of the De&artment

Num%er ofTeaching Staff

No" of studentsin the De&artment ? Facult !

Student0atio

T#Ssst" Prof"" sso" Prof" Professor T

o t a l

+ " ,

"

P " , T

o t a l

T S.ale Female .ale Female .ale Female

3":"=">"G"

Total for the college(totals of a%o'e rows)

No" of staff a&&ointmentratified % the +ni'ersit

No" of staff a&&ointed in thelast = months


8/17

1:, L! * of 'e' er of No"2*e&c$!"g *&ff u..or*!"g *&ff &"( off!ce *&ff /!"clu(e o"l%

*&ff o" roll for &* le& * !) 'o"*$ !" *$e !''e(!&*e .& * 48

De&artment/ la%orator (for each la% se&aratel ) DesignationTechnicians/com&utero&erators/attenders etc

No" ofStaffmem%ers

No" holdingdi&loma orhigher

4thers Secretarialollege office

1;, L! r&r% De*&!l 8

a" T &e of li%rar ,eneral/Digital 8i%rar $ %" 6ualifications of the 8i%rarian $c" Num%er of Su&&orting Staff $d" Total Num%er of Titles of ooks $e" Total Num%er of @olumes of ooks $f" No" of Titles of Technical / Professional *ournals $g" e!7ournal su%scri&tion details if an $h" Seating a&acit of 8i%rar $i" 0e&rogra&hic/Photostat facilit $

7" -orking 1ours of li%rar $

k" n Inno'ation/ s&ecialit !gi'e details $

1=, Ce"*r&l Co'.u*er ce"*re# 8S"

No1ardwares&ecifications

No" of Standaloneom&uters

No" ofom&uterTerminals

No" of Standalone om&uterson 8 N/- N

No" of om&uterterminals on8 N/- N

3:

Details of software &rocured and installed $ No" of Peri&herals / Printers $Internet accessi%ilit (in .%&s/k%&s 2 1ours) $

1>, Ac&(e'!c#E)&'!"&*!o" Sec*!o"

a) Details of 4fficer(s) in charge identified$ %) No" of su&&orting Non!Teaching Staff $c) Details of E;ui&ment &rocured and installed for EDEP Examination$ i) No" of om&uters with internet facilit $

ii) No" of Printers$ iii) Phone with Fax$

i') Photo co& ing (Jerox) e;ui&ment details$ ') Digital o&ier

K


9/17

19, To*&l No, of co'.u*er .urc$& e( &"( u e( !" *$e @$ole collegeS"

No" Name of thela%/de&t"/office/section/li%etc

1ardwares&ecifications

No" of om&uters

standalone

on8 N/- N

Internetconnected

3":"

Total

0, I" *ruc*!o"&l Are& /+!*$ "ece &r% fur"!*ure &"( e u!.'e"* & *$e c& e '&% e4

Particulars Num%er of 0ooms8 x x 1 of the room in

mlear ar&et area

ofEach 0oom (s;"m")

lass 0oomsDrawing 1all

om&uter entre8i%rarll 8a%oratories-orksho&s

,rand Total

1, Ho *el &cco''o(&*!o" (e*&!l /o"l% !f &**&c$e( $o *el *&*u ! re u!re(48

a" 8and 8ocation $ %" Total rea of land (in acres) $ c" No" of uildings and No" of Floors $ d" Total floor area in s;"m $ e" -hether internet is &ro'ided $ f" 0ough sketch of sha&e of the land with a&&roach road

S" No

Name ofthe 1ostelfor %o s /,irls

No" of0ooms

8 x x 1of the

room in m

No" ofinmates

&er room

No" of inmates &er mess

No" ofinmates &ertoilet/ %ath

No" ofinmates &ercom&uter

3":"

, De*&!l of Fee e!"g collec*e( fro' *u(e"* (In all forms/under all heads)

S" No Title of Fee

Fre;uenc(.onthl /&erSemester/ nnual#ear/Entireourse)

mount(0s")

Princi&als %ank/ No" to

which credited

3 Tuition Fee!con'enor ;uota: Tuition Fee!N0I/.anagement ;uota= S&ecial Fee (item wise)> 1ostel feeG I+T Fee

C


10/17

Mo(e of .&%'e"* of S&l&r!e 8 % c& $ # c$e ue # &"? Tr&" fer8

, F!"&"c!&l (e*&!l of *$e I" *!*u*!o" for *$e .rev!ou &c&(e'!c %e&r8

:=(a) Details of 4&erational Funds of the Institution$S"

No" Name of the ank with

ranch 2 Full ddressccount No" ash alance

(0s" in 8akhs)FD09 if an(Excluding

FD0 su%mittedto I TE)

Total amount(0s" in 8akhs)

3":"=">"

:=(%) Income and ex&enditure details for the last financial ear $

S,

No,

Source of I"co'e Ru.ee !"

L&?$

E).e"(!*ure Ru.ee !"

L&?$

1, entral ,o'ernment Salar of full time facult:" State ,o'ernment Salar of 'isiting facult=" +ni'ersit ,rants

ommission (+, )Salar for non!teachingstaff

>" 4ther entral / State,o'ernment %odies

8i%rar

G" Pri'ate Trust om&uter entreH" Donations E;ui&ment for 8a%s and

worksho&" Student Fee 4thers (Please s&ecif )K" Internal 0e'enue generatedC" 4thers (Please s&ecif )

T4T 8

3, S*u(e"* Pl&ce'e"* *$roug$ I" *!*u*!o" Pl&ce'e"* Cell /-r&"c$ +! e48

S" No Name of the ourse/&rogramme with

S&ecialiBation! in short formTotal num%er of

students &assed out(in last : ears)

Total num%er of students &laced through &lacement

cell (in last : ears)3":"=">"G"

35


11/17

:, S*&*u of co'.l!&"ce of .ec!f!c co"(!*!o" of l& * &..rov&l # e)*e" !o" of &..rov&l %

6NT78

S" No S&ecific onditions om&liance Status3":"=">"

;, @$e*$er *$e I" *!*u*!o" ! $&r!"g !* f&c!l!*!e # .re'! e +!*$ &"% o*$er I" *!*u*!o"If %e G!ve (e*&!l

Name and address of the other Institution ou are sharing$Details of Sharing$ am&us/ uildings/8a%oratories/Facult /others (s&ecif )

De*&!l o" *$e follo+!"g !*e' '&% e fur"! $e( !" co"ve"!e"* for' $!g$l!g$*!"g (e*&!l ofc$&"ge #&((!*!o" over *$e l& * %e&r /I* ! '&"(&*or% *o fur"! $ (e*&!l &g&!" * e&c$ !*e'4

: " Drinking water facilit for students/staff (in litres/da ):K" Pota%le water source/arrangement for the re;uirements of the college:C" Power su&&l and a&acit of ,enerator =5" S&orts and games facilities=3" &&roach 0oads=:" .ode of Trans&ort to reach the institute==" Students anteen=>" ommon 0ooms for %o s9 girls and staff =G" Staff ;uarters=H" 1ealth are entre= " ,uest 1ouse=K" onference 1all=C" o!o&erati'e Stores>5" Nearest ank ser'ices>3" Nearest Post office with Pin>:" ollege functions in the last one ear >=" ollege .agaBines>>" Information hand %ooks to the students>G" 1o%% centres>H" 0eading room> " ,rie'ance 0edressal ell>K" NSS 4fficer9 cti'it details>C" S&orts 4fficer9 cti'it detailsG5" Entre&reneur De'elo&ment ellG3" Professional Societ .em%ershi&s a) Indi'idual (Student / Facult ) %) Institutional (National / International)G:" N ccreditation Status$ #es / No If #es9 gi'e details along with co& enclosed"G=" N ccreditation Status$ #es / No If #es9 gi'e details along with co& enclosed"G>" -hether o%tained :(f) 2 3:( ) Status of +, $ #es / No If #es9 gi'e details along with co& enclosed"GG" -hether o%tained utonomous Status of +, $ #es / No If #es9 gi'e details along with co& enclosed"GH" n other good &ractices

33


12/17

De*&!l for E)! *!"g PG cour e !" e)! *!"g College

G " Dates on which First and latest a&&ro'al was accorded % the I TE/P I $GK" Dates on which the First and latest State ,o'ernment &ermitted the course$GC" Facult allotted details for the new P," course $H5" Details of la%orator facilities made a'aila%le along with staff $H3" Details of other e;ui&ment &rocured for the de&artment $H:" Details of infrastructure facilities a'aila%le for the course $H=" Details of the De&artmental 8i%rar facilities de'elo&ed

a" 0ele'ant *ournals National/International $ %" 0ele'ant ooks! Titles and @olumes $c" 0e&rogra&hic facilities $

H>" Details of 1ostel facilities a'aila%le for the students $

De*&!l for *&r*!"g of "e+ PG cour e !" e)! *!"g College

HG" Date on which a&&ro'al was accorded % the I TE/P I $

HH" Date on which the State ,o'ernment &ermitted the course $H " Facult details identified for the new P," course $HK" Details of la%orator facilities setu& along with staff $HC" Details of other e;ui&ment &rocured for the de&artment $5" Details of infrastructure facilities identified for the new course $3" Details of the De&artmental 8i%rar facilities de'elo&ed

a" 0ele'ant *ournals national/international $ %" 0ele'ant ooks! titles and 'olumes $c" 0e&rogra&hic facilities $

:" 1ostel facilities for the students $=" Date of N4 issued % +ni'ersit $

3:


13/17

Re.or* of !'.rove'e"*# c$&"ge over *$e (&*& of .rev!ou %e&r u '!**e( *o 6NT7A If there are an changes in the following items of the a&&lication9 kindl gi'e details! If there are no changes write no change

1, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

3, /!4 +& *$e Off!cer co"*!"u!"g fro' 009210 !f "o* g!ve (e*&!l of c$&"ge *!ll (&*e

3, /!!4 +& *$e off!cer +& o" le&ve or *$e .o !*!o" lef* v&c&"* for 'ore *$&" 1: (&% (ur!"g.& * %e&r If %e *$e" g!ve "o, of *!'e .er!o( +!*$ (&*e &"( re& o" +!*$ &l*er"&*e&rr&"ge'e"* '&(e *$erefor,

;, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

=, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

>, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,9, -hat new areas are added and are the according to master &lan &ro'ided in Detailed Pro7ect0e&ort su%mitted at the time of ince&tion" ,i'e details

1 " a" New teaching staff 7oined the college/instt" with names9 De&artment and designation

%" Teaching staff who left the college/Instt" with names9 De&artment and designation

c" Teaching staff who got &romoted/selected to higher &ost with names9 De&artment and &resent designation

d" Teaching staff who got their ;ualifications im&ro'ed with names and new ;ualification

13, Total cost of the e;ui&ment &rocured and details of new la%s setu&"

1:, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

1;, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

1=, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

1>, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,




;, De*&!l of c$&"ge 8 Ye #No, If Ye .le& e g!ve (e*&!l ,

3=


14/17

De*&!l *o e &..e"(e( *o *$e &..l!c&*!o"

o&ies of the following attested % ollege Princi&al / hairman of Trust as the case ma %e

3" First &&ro'al letter of I TE / P I"

:" First ffiliation granted % *NT+/*NT+ "=" 8ast four ears grant of ffiliation letters of *NT+ "

>" The status (,eneral / .inorit / -omen) grant % the State ,o't"

G" 0emittance details of ffiliation / Ins&ection fee for the &ast four ears"

H" Date of irth9 Educational9 Em&lo ment ex&erience of the Princi&al / Princi&alsofficiated for the last two ears along with their recent Photogra&hs"

" Societ 0egistration ertificate"

K" 8and sale deed and usage con'ersion certificate"

C" .aster &lan of infrastructure de'elo&ment as gi'en in the first Detailed Pro7ect 0e&ort".arking the areas of com&leted construction9 incom&lete construction and et to startconstruction"

35" ,o'erning od constitution and .inutes of the last two ,o'erning od meetings"

33" 0e&ort of ollege cademic ommittee for the last one ear"

3:" 0e&ort of the ,rie'ance 0edress ommittee for the last ear"

3=" hartered ccountant s udit 0e&ort for the financial ear :53:!3="

3>" Details of Teaching facult De&artment wise se&aratel in the format gi'en %elowN&'e of *$e De.&r*'e"*8

Photogra&h Name of the Staff.em%er 2ontact No"

6ualifications withS&ecialiBation if an

T e a c h

i n g

E x & e r

i e n c e

i n ( e a r s

Names of Su%7ects handledin the &ast G ears with no"of times handled

Te&c$!"g S*&ff (e*&!l for'&*8S,No, De.&r*'e"* N&'e 5 De !g"&*!o" M#F u&lf!c&*!o" D&*e of SSC 7G PG P$,D

3":"

3>


15/17

DECLARATION

Cer*!f!e( *$&*8

a" The Institute is not offering an academic &rogramme9 which is not a&&ro'ed % *NT+ "

%" The intake in an of the *NT+ a&&ro'ed courses has not %een increased %e ond thesanctioned intake9 without its &rior a&&ro'al"

c" The %uilding and &remises in which the institution is functioning is not %eing / will not %eutiliBed for an other courses/ &rogrammes which are not a&&ro'ed % the State ,o't" /*NT+ "

d" ll ourses are and will %e conducted as &er norms9 standards and guidelines of the*NT+ and follow all the rules and regulations of the uni'ersit as s&ecified from timeto time"

e" The teaching facult and staff ha'e %een recruited as &er ;ualifications and ex&erience aslaid down % the I TE/*NT+ "

f" The I TE scales of &a and allowance ha'e %een granted to the teaching facult "

g" The admissions are made on merit and as &er State ,o't" and *NT+ admissionguidelines and no ca&itation fee or donation of an kind is charged for admission"

h" The tuition and the other fee are charged within the criteria &rescri%ed % the om&etentuthorities ( dmissions and Fee 0egulator ommittee of the State ,o't")"

i" The accounts of the institution are %eing maintained as &er the &ro'isions of rele'antstatutes and a hartered ccountant audits"

7" ll the mone transactions collection of different fees9 &a ment of salaries9 dis%ursementof scholarshi&s etc" are done through %ank onl and trans&arenc is maintained"

k" ll the &h sical deficiencies stated in the last a&&ro'al letter for +, 2 P, &rogrammesha'e %een remo'ed"

-e solemnl declare that no information has %een with held and all the information &ro'ided in this a&&lication form is true" If an information is found to %e incorrect or false9we understand that the &ro&osal shall %e lia%le for re7ection and / or an action % *NT+ "

N&'e &"( S!g"&*ure of *$e N&'e &"( S!g"&*ure of *$eC$&!r.er o"#Secre*&r% of *$e Soc!e*% He&( of *$e I" *!*u*!o"

3G


16/17

FORM AA9E0

Recor( #D&*& *o e $o+" *o *$e F&c* F!"(!"g Co''!**ee for &ff!l!&*!o" &.&r* fro'

*$o e !*e' g!ve" !" *$e &..l!c&*!o" /& &..l!c& le for *$e college4,

3" 4riginal 8atest &&ro'al letter from I TE"

:" 4riginal 8atest &&ro'al letter / order from ,o'ernment

= 4riginal 8atest ffiliation letter from +ni'ersit

>" 8atest ank Statements and Fixed De&osits showing the financial status of the Instituteattested % the %ankers

G" .aster Plan of the entire Institution com&lete with details of &linth area9 including area

of 8a%oratories9 lass rooms9 Drawing 1alls9 -orksho&s9 8i%rar 9 etc"

H" 4riginal 8and Documents

" &&ointment letter9 *oining re&ort and 4riginal ertificates of the Princi&al

K" &&ointment letters and re&orting letters and 4riginal ertificates of the staff mem%ers"

C" ttendance 0egister of the staff mem%ers (Teaching and Non!teaching)

35" ank accounts in the name of the Princi&al and the latest %ank statements of the same

33" Salar c;uittance 0egister of the Staff mem%ers (Princi&al9 Teaching and Non!teaching)

3:" Proof of showing mode of &a ment of salaries

3=" Stock 0egister of 8a%orator 9 8i%rar and other stock such as generator9 s&orts kits withthe &roofs9 which indicate that the &a ments are made (recei&t from the su&&lier etc")

3>" 4riginal 8icenses of Software

3G" set of S lla%us ooks (of *NT+ ) for the &ro&osed courses at our Institution

(The Details against items 3H to = should %e shown for the last : ears or from the ince&tion ofthe college / course which e'er is later)

3H" Students attendance 0egisters

3 " 0egister of dmissions9 Transfers and withdrawals

3K" lass Time Ta%les

3C" 8a%orator records of the students

:5" 0ecords of Examination %ranch of the ollege

3H


17/17

:3" 0ecords of &lacement cell showing the &roof of &lacement students

::" Practical Examination Scri&ts

:=" nswered Internal Examination ;uestion/ nswer &a&ers

:>" Internal .arks sent to +ni'ersit

:G" ttendance records/re&orts sent to +ni'ersit

:H" Proof indicating the dis&la of ttendance and Internal .arks in the Notice oards

: " +ni'ersit 0esults sheets indicating the &erformance of students

:K" 0ecords of the fee collected with recei&ts"

:C" 1ostel records"

=5" Income and Ex&enditure sheet of the institution with udited statement"

=3" Dates of ,o'erning od .eetings conducted with minutes of the meeting"

=:" Dates of ollege cademic ommittee .eetings conducted with minutes of the meeting"

==" Dates of ,rie'ance 0edress ommittee .eetings conducted with minutes of the meetingincluding anti ragging/ ragging &re'enti'e measures taken"

=>" +ni'ersit 0atification 8etter for a&&ointment of teaching staff

=G" 8imitations / shortfalls indicated % earlier ffiliation Ins&ection ommittee 2 ctiontaken"

=H" Students Feed %ack and the action taken in res&onse to the students feed %ack"

= " Staff a&&raisal and the action taken in %ased on the staff a&&raisal"

3

Date post:	03-Jun-2018
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