Académique Documents
Professionnel Documents
Culture Documents
AffiliationformforNew/Renewal,Adhoc/PermanentAffiliation
programmecoveredunderArts,Commerce&ScienceFaculties
To,
The Registrar,
Gujarat University,
Navrangpura, Ahmadabad-380009
Sub: Application of Affiliation for: New Institute / Extension of Affiliation & / Additional course in
existinginstitutewithGujaratUniversityfortheAcademicsession20152016.
1. NameandAddressoftheSociety/Trust:
RegistrationNumberofthe
Trust/Society:
Name
Address
Taluka
District
PinCode
PhoneNo.withSTDCode
FaxNo.withSTDCode
EmailID
Website
2. NameandAddressoftheCollege/Institute(Existing/Proposed)
Name
Address
Taluka
District
PinCode
PhoneNo.withSTDCode
FaxNo.withSTDCode
EmailID
Website
HasGujaratGovernment
Yes/No/NotRequired
issuedNOC?
Has
NCTE/AICTE/MCI/DCI/BCI/ Yes/No/NotRequired.
CCHrecognized?
Ifappliedin
NCTE/AICTE/MCI/DCI/BCI/
..//
CCH,indicatedateof
application.
IDIssuedGujaratUniversity
IDIssuedby
NCTE/AICTE/MCI/DCI/BCI/
CCH/
3. DetailedofAcademicProgrammesforwhichAffiliationisProposed:
NameofFaculty
NameofProgramme
UnderGraduate/Post
Graduate
MainSubject
SubsidiarySubject
AcademicYear
No.ofDivision
Time
Whichtypeofeducation
4. DetailedisrequiredasperSection33GujaratUniversity:
Sr.
Particulars Details
No.
1 PopulationofVillage/City
2 DetailsofCollegesprovidedsame
educationnearby
3 TypeofEducation
(OnlyWomen/Coeducation)
4 ExpatiationofIntakeofStudents
5 ReasonforOpeningnewCollege
6 DefineAreaofCollege
7 MediumofStream/Instruction
5. WhetherCollege/InstituteisGovernment/Aided/UnAided:Govt./Aided/UnAided
6. WhetherCollege/InstituteisregisteredasaMinorityColleges?:Yes/No
7. IfYes,typeofMinorityLinguistic/Religionetc.::Linguistic/Religion
8. NameandAddressoftheExistingCollege/InstituterunbytheSociety/Trust
9.
LandAvailability(Attachalltherecords)
Sr Parameter Details
1 LandCategory MetropolitanCity/OtherArea
AreaRequiredasperLandCategory
2 1.5Acres/2.0Acres/5.0Acres
(Acres)
3 TotalAreaAvailable(Acres)
PlotNo.:
4 LandDetails SurveyNo.:
BlockNo.:
5 LandAddress
WhetherLandisownedbyTrust?
6 (Attach7/12,8A,6Certificates) Yes/No
WhetherLandisundisputed?If
7 disputed,specifydetailsofdispute Yes/No
withdocuments
WhetherLandisNA?IfYes,mention
8
NAOrderandDate.(AttachNAOrder)
WhetherLandisfreeofanydebt?
9
(Attachcertificate)
Whetherthesaidlandisdemarcated
10 byFencing/boundarywallforthe Yes/No
College/Institution?
11 Whetherthesaidlandiscontiguous? Yes/No
10.
BuildingAvailability(Attachalltherecords)
Area(LengthXBreadth)(inSquare
Sr ParticularsforEachUnit
Meters)
1 Length:Meter
TotalClass Breadth:Meter
Room Area:.Meter
2 Length:Meter
Tutorial Breadth:Meter
Room. Area:.Meter
3 Laboratory Length:Meter
Breadth:Meter
Area:.Meter
4 DrawingHall Length:Meter
Breadth:Meter
Area:.Meter
5 Workshop Length:Meter
Breadth:Meter
Area:.Meter
6 SeminarHall Length:Meter
Breadth:Meter
Area:.Meter
7 ComputerCenter/ Length:Meter
Breadth:Meter
Area:.Meter
8 Library/Reading Length:Meter
Breadth:Meter
Area:.Meter
9 Reading Length:Meter
Breadth:Meter
Area:.Meter
11. TotalInstructionalArea(CarpetArea)inSquareMeter
ForExistingIntake
For Numbers Area
Particulars
UG/PG
Required Available Required Available
ClassRooms
TutorialRooms
Laboratories
DrawingHall
Workshop
SeminarHall
ComputerCenter
LibraryandReading
Room
Total
12. Administrative/AmenitiesArea(CarpetArea)inSquareMeter
ForExistingIntake
Particulars Numbers Area
Required Available Required Available
Principal/DirectorOffice
BoardRoom
OfficeallInclusive
DepartmentOffices
CabinsforHeadofthe
Departments
FacultyRoom
ExaminationsControlOffice
PlacementOffice
CentralStores
Maintenance
Security
HouseKeeping
PantryforStaff
Toilet(StaffMale)
Toilet(StaffFemale)
Toilet(Boys)
Toilet(Girls)
BoysCommonRoom
GirlsCommonRoom
Cafeteria
StationeryStoresandReprography
FirstAidcumSickRoom
Parking
PlayGround
13.
WhetherhasGoverningBodybeenconstituted?Yes/No
14. IfYes,mentionlastdateofmeeting:.............................................................................................................
14.IfYes,mentionConstitutionandCompositionoftheGoverningBody
Sr NameandAddress Designation
PhoneNo.withSTDCode.:
1 MobileNo.: Chairman/President
Email:
PhoneNo.withSTDCode.:
2 MobileNo.: ManagingTrustee/Secretary
Email:
PhoneNo.withSTDCode.:
3 MobileNo.:
Email:
PhoneNo.withSTDCode.:
4 MobileNo.:
Email:
PhoneNo.withSTDCode.:
5 MobileNo.:
Email:
PhoneNo.withSTDCode.:
6 MobileNo.:
Email:
PhoneNo.withSTDCode.:
7 MobileNo.:
Email:
PhoneNo.withSTDCode.:
8 MobileNo.:
Email:
PhoneNo.withSTDCode.:
9 MobileNo.:
Email:
10 PhoneNo.withSTDCode.:
MobileNo.:
Email:
15. NameandDesignationofHeadoftheCollege/Institute(Principal/Director)
Name
Designation
Qualification
Experience
HighestDegree
Specialization
TotalExperience
DateofBirth
(O):
PhoneNo.withSTDCode (R):
(M):
FaxNo.withSTDCode
EmailID
WhetherApprovedbyGujaratUniversity?
IfYes,pleasementiontheApprovalLetterNumberand
Date
16. TeachingStafffortheexistingprogramme(s)
Designation&
Type
(Prof/Asso
Category PayBand, University
Prof/AsstProf
S (SC/ST/ Qualific Dateof GradePay Recognition
Name &Permanent/
r SEBC/ ation Joining &Total LetterNo.&
Probation/
OTH/PH) Salary Date
Adhoc/Part
Time/
Visiting)
UG:
PG:
1
MPhil:
Total: PhD:
UG:
PG:
2
MPhil:
Total: PhD:
UG:
PG:
3
MPhil:
Total: PhD:
UG:
PG:
4
MPhil:
Total: PhD:
UG:
PG:
5
MPhil:
Total: PhD:
UG:
PG:
6
MPhil:
Total: PhD:
UG:
PG:
7
MPhil:
Total: PhD:
UG:
PG:
8
MPhil:
Total: PhD:
UG:
PG:
9
MPhil:
Total: PhD:
UG:
1 PG:
0 MPhil:
PhD:
17. Registrar/OfficeSuperintendent
NameoftheRegistrar/OfficeSuperintendent
Qualification
DateofAppointment
DateofJoining
DateofBirth
PhoneNo.withSTDCode (O):(R):(M):
Email
18. NonTeachingStaffDetails
19. SupportingStaffDetails(AsperListAttached)
Category Designation
PayBand,
(SC/ST/ (Permanent Dateof
Sr Name Qualification GradePay&
SEBC/ /Probation Joining
TotalSalary
OTH/PH) /Adhoc)
1
Total:
2
Total:
3
Total:
4
Total:
5
Total:
6
Total:
7
Total:
8
Total:
9
Total:
10
Total:
20. Librarian
Name
Qualification
Experience
TotalExperience
DateofAppointment
DateofJoining
DateofBirth
(O):
PhoneNo.withSTDCode (R):
(M):
FaxNo.withSTDCode
EmailID
WhetherApprovedbyGujaratUniversity?
IfYes,pleasementiontheApprovalLetterNumberand
Date
20(a).LibraryStaffDetails
Category Designation
PayBand,
(SC/ST/ (Permanent Dateof
Sr Name Qualification GradePay&
SEBC/ /Probation Joining
TotalSalary
OTH/PH) /Adhoc)
1
Total:
2
Total:
3
Total:
4
Total:
5
Total:
6
Total:
7
Total:
8
Total:
9
Total:
10
Total:
20(b).LibraryFacilities
Sr Particulars Availibility
1 TotalAreaoftheLibrary
2 SeatingCapacityoftheLibrary
3 ReprographicFacility Yes/No
4 WorkingHoursoftheLibrary ..am/pmto.am/pm
5 LibraryNetworkingFacility Yes/No
UsageDataoftheLibrary(intermsofbooks
6
issuedtothefacultyandstaffetc)
AnnualLibraryBudget(percentageofannual
7
studentfeecollected)
8 NumberofComputersinLibrary
LocalAreaNetwork
IfYes,mentionServerHardware Yes/No
Configuration HardwareConfiguration:
9 IfYes,mentionServerSoftware
Configuration SoftwareConfiguration:
10 InternetFacilityinLibrary Yes/No
11 ReadingRoom Yes/No
12
13
14
15
20(c).DetailsoftheLibraryBooks
TotalNumberof NumberofJournals
Sr TotalNumberofTitles
Volumes National International
1
2
3
4
5
21. ComputerFacility
PeripheralswithConfiguration
No.of
Sr Program Course Configuration (Printers,Scanners,LCD
Computers
Projector,
22. LocalAreaNetworkDetails:
22(a).InternetFacilityDetails:(PleaseattachPhotostatcopyoftheBill)
InternetService
Provider
Leased
TypeofConnectivity
Line/Broadband/Dongle/.
ConnectionType Dedicated/Shared
Speed
.MBPS
WiFi Yes/No
23.AuditedBalanceSheetAttached?Yes/No
24.FinanacialDetailed:Deposits/Bonds/Cashandanyother(Copyattached)
25.OtherFacilities
Sr Parameter Availability
1 LanguageLaboratory
2 AllWeatherApproachRoad
3 PotableWaterSupply
4 ElectricalGenerator
5 DigitalLibrary
6 ParkingFacilities
7 MedicalFacilities
8 InsuranceFacilities
ReprographicFacilitiesinthe
9
College/Institute
10 SewageDisposal
11 TelephoneandFax
GeneralNoticeBoardandDepartmental
12
NoticeBoards
13 MedicalandCounselingFacilities
14 College/InstituteWebsite
15 FirstAidFacility
16
17
18
19
20
21
22
23
24
25
Iherebyundertakethat
(NameofthePresident/SecretaryofTrust/Society)