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Ration Card Application Form in Tamil - DOC

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Ration Card Application Form in Tamil - DOC Powered By Docstoc
					                     MANONMANIAM SUNDARANAR UNIVERSITY
                              TIRUNELVELI-627012


                    APPLICATION FORM FOR LEARNING CENTRE

                                                                                        Affix the
                                                                                      Passport Size
                                                                                      photo of the
                                                                                        Director


Please fill up this form and attach supporting documents.
   1.      Name of the Registered Institution/ Trust/ Society: (Please attach Deed)




   2.     Address with Pin code:
           a) Postal Address:




             City:                                                   Pin Code:

            b) Email Address:



   3.       Telephone Nos with STD Code:

                a.   O             -

                b.   R             -

                c.   Mobile        -

                d.   FAX           -

   8.   Name of the Head of Institution with Complete Address:




            City:                                                     Pin Code:

                                                                                                      1
                      MANONMANIAM SUNDARANAR UNIVERSITY
                               TIRUNELVELI-627012



9. Work Experience of Management:



10. Any collaboration / proposed collaboration with any other university for any other programs:

         a.    Name of the University:




         b.    University Address:




         c.    Programs being undertaken:

               I. Diploma                   :
              II. Undergraduate             :
              III. Post Graduate            :
              IV. Any other Program :

11. Number of Modules from EDUVISE:

a)      Minimum 6 Programmes. Kindly mention below the Details of programmes
        selected:

1. _________________
2. _________________
3. _________________
4. _________________
5. _________________
6. _________________

b)      All the programmes offered under Distance Mode.




                                                                                                   2
                  MANONMANIAM SUNDARANAR UNIVERSITY
                           TIRUNELVELI-627012



12. The following minimum area is required:

   Area       :       2,500-3,000 sq. ft

13. Centre Area available is : ________________sq.ft (Please attach the supportive document
    for the same with application)




                                                               Signature of the Director
                                                               With Study Centre Seal




                                     For Official Use Only

 Recommended for Inspection                   : Yes    No


                                      _________________________________
                                            Authorised Signatory




                                                                                           3
                MANONMANIAM SUNDARANAR UNIVERSITY
                         TIRUNELVELI-627012



                                                                          (Annexure-I)


                               Terms and Conditions

1. Description of Payment Mode:

 S.No.        DD No.           DD Date           Amount          Authorised Signatory
                                                 (in Rs.)
   1.




   2




Note: The payment will be made through a DD in the name of “Eduvise Education Advisory”,
      payable at Gurgaon.




                                                               Signature of the Director
                                                                With Study Centre Seal




                                                                                        4
                      MANONMANIAM SUNDARANAR UNIVERSITY
                               TIRUNELVELI-627012




                                             Annexure-A


The Application Form without following annexures will be considered incomplete and will be liable

to be rejected:

1.           a. Self Declaration Form on Stamp Paper of Rs. 100/- (Annexure-II)

             b. Declaration for Training Facilities (Annexure-III)

             c. Address Declaration on Letterhead of Learning Centre (Annexure-IV)



2. Institution

            a. Copy of the Incorporation Certificate

            b. Copy of the MOU / Partnership Agreement / Trust Deed duly attested by a Gazetted

                  Officer.

            c. Last financial year’s Form – 16 & Tax certificate

            d. Last 1 Year Bank Statement attested by the Bank Manager



3. Head / Partners / Board of Directors / Trustees of the Institution

            a. Detailed Resumes of all members of management & Faculty with 04 photographs each

                  for both Senior Management & Faculty Members.

            b. Residential Proof. (PAN Card, Ration Card, Passport, etc.)

            c. Name & Address of Bank

            d. Last 1 Year Bank Statement attested by the Bank Manager




                                                                                                  5
                 MANONMANIAM SUNDARANAR UNIVERSITY
                          TIRUNELVELI-627012




                              On Stamp Paper of Rs. 100/-

                                                                              (Annexure-II)

                              SELF DECLARATION FORM

I/We hereby apply for my/our Learning Centre for Session 2010-11. I/We hereby
undertake as under:

   1. To pay all the outstanding dues.
   2. To pay all the fees as per the University Norms.
   3. Not to charge any extra fees from the students apart from the fees prescribed in
       the prospectus.
   4. To have the format of my/our advertisement approved by the University before
       I/We release it to the media.
   5. To submit all the forms to the University within the prescribed time limit.
   6. To deliver minimum number of counseling hours as per the norms of the
       University.
   7. To individually verify all the documents enclosed with the student forms with the
       originals.
   8. To take full responsibility of all the documents/correspondences signed by my
       staff on my behalf.
   9. Not to indulge into any sort of criminal/immoral/illegal activity.
   10. I will not run Regular Classes of the University Courses under DLP Programme.
       As under DLP Programme only Contact Classes are permitted. If any institution
       found running Regular Classes under DLP the Authorization given by the
       University will be cancelled without any notice. The fee money deposited with the
       University will be forfeited.

I/We, further acknowledge that if at any point of time the University finds any deficiency
in my/our infrastructure or in the support services to the students or if I/we am/are found
involved in any sort of unlawful activities, then the university will have the full right to
terminate my/our learning centre authorization without seeking my/our clarification.


For_______________________________



Signature of the Study Centre Head
(With Seal/Stamp)


                                                                                           6
                MANONMANIAM SUNDARANAR UNIVERSITY
                         TIRUNELVELI-627012




      ON THE LETTER HEAD OF THE INCHARGE OF THE TRAINING CENTRE

                                                                       (Annexure-III)

                    DECLARATION FOR TRAINING FACILITIES

To,

The Director,
Manonmaniam Sundaranar University
Tirunelveli-627 012
Tamil Nadu (INDIA)


Dear Sir/Madam,

After careful analysis of University minimum norms, I assure you that we have all
facilities as per the requirement of the course__________________________________
for the students enrolled in Directorate of Distance Education, Manonmaniam
Sundaranar University, Tirunelveli, Tamilnadu.

We have NO OBJECTION for the premises being used by the University Program
Learning Centre. The University inspection team can visit/inspect the premises at any
time.

Name of the Learning Centre     ___________________________________________
                                ___________________________________________
                                ___________________________________________
                                ___________________________________________
                                ___________________________________________
                                ___________________________________________
                                Phone__________________Fax ________________

Duration of Agreement from________________to______________ at least for 3 years)




Authorised Signatory of Learning Centre           Signature of Learning Centre Head
        (With Seal/Stamp)                                 (With Seal/Stamp)

                                                                                      7
                   MANONMANIAM SUNDARANAR UNIVERSITY
                            TIRUNELVELI-627012



                     ON THE LETTER HEAD OF THE LEARNING CENTRE

                                                                                       (Annexure-IV)

                                     ADDRESS DECLARATION

                                 In Case the Learning Centre is Owned

I, do hereby declare that I own the under mentioned premises which complies with the University
requirement and wherein I intend to run the Learning Centre of Manonmaniam Sundaranar University,
Tirunelveli-627 012, Tamil Nadu.

Address of the Premises         ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________

I, submit to you the following documents as address proof of the proposed Learning Centre Premises:

   1. Copy of Purchase Agreement
   2. Latest Electricity Bill of the Premises

For_____________________________________


Signature of the Learning Centre Head
(With Seal/Stamp)
________________________________________________________________________

                                 In Case the Learning Centre is Rented

I, do hereby declare that I have acquired the under mentioned premises on rent/hire/leave & license
which complies with the University requirement and wherein I intend to run the Learning Centre of
Manonmaniam Sundaranar University, Tirunelveli-627 012, Tamil Nadu.

Address of the Premises         ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________
                                ____________________________________________________

I, submit to you the following documents as address proof of the proposed Learning Centre Premises:

   1. Leave & License Agreement or NOC from owner
   2. Latest Electricity Bill of the Premises

For_____________________________________


Signature of the Learning Centre Head
(With Seal/Stamp)
                                                                                                      8

				
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