A Constituent College of the University of Allahabad College with Potential for Excellence Status Awarded by Form No

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A Constituent College of the University of Allahabad College with Potential for Excellence Status Awarded by Form No Powered By Docstoc
					                        ( A Constituent College of the University of Allahabad)
                      College with Potential for Excellence: Status Awarded by                           Form No.
                                    UGC Graded B++ by NAAC.                                              For Office use only
                                         B.Ed. Application Form - 2009

1.    Name

                             First                                   Middle                               Surname

2.    Date of Birth     date                  month                  year

3.    Father’s Name
                                                                                                           PASTE YOUR RECENT
4.    Mother’s Name
                                                                                                              PASSPORT SIZE
                                                                                                              CAMERA FACING
5.    Category (tick mark) (i)                        (ii) SC / ST          (iii)    GEN.
                                                                                                           PHOTOGRAPH HERE
6.    If Christian then specify Denomination

7.    Tick mark the qualifying examination B.A.:                 B.Sc. :             B.Com.:

8.    Details of qualifying examination :

      B.A./ B.Sc.       Year          University      Marks          Max.            Percentage               Subjects
       B.Com.                                        Obtained        Marks
      1st Year
      2nd Year
      3rd Year
                                      Total Marks

9.    Details of other academic records :
       Name of          Year          Board /          Division      Percentage                          Subjects
      Examination                    University
      High School/
      Higher Sec.
      M.A./ M.Sc./
      If any other,

10.   Please tick two subjects from the following which you offered at graduation/ post-graduation level.

      English           Hindi                     Pol. Science                      Economics                   Geography
      History           Botany                    Zoology                             Physics                   Chemistry
      Maths             Education                 Commerce

11.   Tick mark two subjects from the following which will be your practice teaching subjects

      English                            Hindi                    Maths                         Gen. Science (Phy./ Che.)
      Biology (Bot./ Zoo.)               History                  Geography                     Civics
      Economics                          Commerce
12.       Extra Curricular activities ( Fill up Y for YES and N for NO in the box).
          (a) Games

                           National                  State            Inter-University                   Inter-College

          (b) N.C.C.       C                          B               G2                                 G1

          (c) N.S.S.                  240 hrs + 2 Camp                240 hrs + 1 Camp                   240 hrs

          (d) Scout/ Guide/ Rover Ranger         National                  Governors                     Gurupad
          (e) Any others
13.       (i) Was your Father/ Grandfather a freedom fighter ? ( Attach Photocopy of Certificate)
          (ii) Is you Father/ Husband a defence employee or retired defence/ civil defence employee ?
              ( Attach Photocopy of Certificate)
          (iii) (a) Are you a Teacher ? ( Enclose certificate signed by Regional Higher Education Officer/ District
                    Inspector of Schools/ Basic Shiksha Adhikari/ Regional Inspector of Girls School )

          (iii) (b) Are you a Teacher’s/ Non-Teacher staff ward ?                      Yes               No

          (iv) For female candidates - if widowed/ divorced or abondoned (attach photocopy of legal certificates
               to this effect)
14.       Parent’s or Guardian’s Name ________________________________ Designation ___________________
          Permanent Address ______________________________________________________________________
          ______________________Pin ___________ Tel. No. _______________ Mobile No. __________________

Declaration :
           I declare that the information given in the form is true and correct. I have read the College prospectus and the
      contents of the application form. I promise to abide by the College rules and regulations. I agree to pay the prescribed
      fees mentioned in the prospectus. My admission will stand cancelled if the University does not approve it. I under-
      stand that falsification of any of the above entries made in the form or certificates/ mark sheets submitted by me or
      use of any unfair means shall lead to the cancellation of my admission granted at any time. I have no objection to
      participating in any of the college activities.
          I agree not to be working with any organisation during my period of study at Ewing Christian College, Allahabad.
      My failure to submit a NO OBJECTION CERTIFICATE from the employer for joining the B.Ed. course will disqualify
      me from admission.
                                                                                               Signature of Applicant
          Signature of Parent/ Guardian                                                        Date ....................... 2009
15.       Please list/ tick the enclosures/ other certificate(s) :
          (a) High School/ equivalent examination certificate.     (b) B.A., B.Sc., B.Com. Part I, II, III mark sheet.
          (c) Caste certificate. (SC/ST only)                      (d) No objection certicate from the employer, if employed
          (e) Church Sponsorship Certificate.                       (f) Baptism certicate (Christian candidate only).
             (Christian candidate only).

          (g) Other certificate : Games & Sports             N.C.C.           NS.S.            Scouts & Guide
              Freedom Fighter         Defence Employee Ward           Teacher/ Non-Teaching Staff Ward             Teacher
               Widow/ divorced/ abondoned            Any other

                                                  ( For College use only)
          1. Application form checked by : 1 ________________ 2 ________________ 3 _____________________
          2. Privilege marks claimed on account of various categories mentioned on pg. 10 & 11 of the prospectus.
          3. Total no. of enclosures ______________________________
          4. Total privilege marks claimed by candidate ______________________ (not exceeding 25 marks)
                         ( A Constituent College of the University of Allahabad
                                      B.Ed. Application Form - 2009 )

                                                   ADMIT CARD.Ed. Application Form - 2007
Tick the qualifying examination :    B.A.               B.Sc.         B.Com. :            Form No. _____________
1.   Name                  _______________________________________________
2.   Father’s Name :     _____________________________________________
3.   Mother’s Name :      _____________________________________________                       PASTE YOUR RECENT
4.   Address :             ______________________________________________                       PASSPORT SIZE
                                                                                                CAMERA FACING
                           ______________________________________________                     PHOTOGRAPH HERE
5.   TEST DATE & TIME : ______________________________________________

        S.No.          Date                        Time                  Paper                       Place

         1.         06-06-2009              9 :00 a.m. to 12:00      Language & G.K.            E.C.C., Allahabad

         2.         06-06-2009              1:00 p.m. to 4:00 p.m.   Teaching Aptitude Test     E.C.C., Allahabad

         3.         06-06-2009              4:30 p.m. to 5:30 p.m.   Biblical Knowledge         E.C.C., Allahabad

     * Candidate should fill in his/her Name, Father’s Name, Mother’s Name and Address.
     * Candidate should sign his/her admit card in the Examination Hall in the presence of the invigilator.
     * Candidate must bring this admit card, two black/blue ball pens and HB pencil and eraser He/She must occupy
       his/her seat at least 30 minutes before the test time.
     * Your Form No. will be used as Entrance Test Roll Number, Note it carefully.
     * For Church sponsored Christian candidates only.

                            This Admit Card is to be produced at the time of Admission.

     List of enclosure received from the candidate :
     1. Games/ Sports
     2. N.C.C.
     3. N.S.S.
     4. Scout/Rover/Guide/Ranger
     5. Freedom Fighter’s ward
     6. Defence/ Civil defence employee ward
     7. Teacher (Self)
     8. Teacher’s/ Non-Teaching staff ward.
     9. Widowed/ divorced/ abondoned woman candidate
     10. Any other

                                               Total No. of enclosure received

     Date _______________                                                        (Signature of the Receiving Person)

     Note :
        At the time of admission :
        1.    Original documents in support of your claim for privilege marks have to be shown.
        2.    Original Migration/transfer certificate is to be submitted at the time of admission.
                                           ATTENDANCE SHEET
                                            B.Ed. ENTRANCE TEST - 2009
                                           (To be submitted with the application form)
     To be filled in by the candidate :                                                  Form No.
1.   Candidate’s Name      _____________________________________________
2.   Father’s Name :        _____________________________________________
3.   Mother’s Name :        _____________________________________________
                                                                                                    PASTE YOUR RECENT
4.   Address :             _____________________________________________                               PASSPORT SIZE
                                                                                                       CAMERA FACING
                                                                                                    PHOTOGRAPH HERE

        Signature of the candidate _____________________________________

     Date                Day                 Time                    Full signature of the            Full signature of
                                                                  candidate in presence of               invigilator
     06-06-2009       Saturday            9:00 a.m. to 12:00
                                             Paper I
     06-06-2009       Saturday        1:00 a.m. to 4:00 p.m.
                                             Paper II
     06-06-2009       Saturday        4:30 p.m. to 5:30 p.m.
                                     (Spl. Test for Christian

     Note : Invigilators are requested to obtain the signature of the candidate and counter sign in the space

                                     UNDERTAKING (By Graduation Passed)

     This is to certify that I have already passed my graduate examination in the year ____________

     from_________________________________ University and have obtained ________________ % marks.

                                                                                                    Signature of Applicant

                                     UNDERTAKING (By Part III Appearing)

     This is to certify that I have already passed my Part I and Part II examination in the year ____________ from
     ________________________________ University and have obtained _______________ % marks.

        I have appeared in Part III examination and in case I can not produce final year original mark sheet or fail

     to fulfill the eligibility at the time of admission, my candidature shall stand cancelled automatically.

                                                                                                    Signature of Applicant

Description: B.Ed Application Form document sample