9. DECLARATION TO BE SIGNED BY THE CANDIDATE AND TO BE ENDORSED BY THE FATHER OR GUARDIAN :
UNDERTAKING
I Mr./Ms._______________________________________________________________________ hereby declare that I am seeking admission in the DIRECT
SECOND YEAR (COMP.ENGG. / ELEX ENGG. / EXTC ENGG../I.T.) course in Padmabhushan Vasantdada Patil Pratishthan’s College of Engineering on
my own.
1.
I have read all the rules of admission for the year 2014 – 2015 and undertake to abide the same.
2.
The information given by me in my application is true to the best of my knowledge and belief.
3.
I have not been debarred from appearing at any examination held by Govt. , University, College or any statutory body in India.
4.
I hereby agree to conform to any rules, acts and laws enforced by Govt. and I hereby undertake that so long as I remain student of the college, I will do
nothing either inside or outside the college which may result in disciplinary action against me under the rules, acts and laws.
5.
I fully understand that the Principal of Padmabhushan Vasantdada Patil Pratishthan’s College of Engineering, Sion-Chunabhatti, Mumbai will have full
authority to expel me from the college for any infringement of the rules of conduct and discipline.
6.
I am aware that there is likely to be a change in fee structure and I undertake to pay fee, whatsoever approved by the Shikshan Shulka Samiti.
7.
I shall not ask for a transfer from this college to any other college.
8.
I am aware that, I will not be allowed to appear for the examination if I do not attend 75% classes in theory and 100% practicals.
9.
I also know that, I will not be allowed to appear for the examinations if I fail to submit the satisfactorily all the assignment, jobs, journals, drawing,
report as specified by the norms of University within stipulated time.
10. I am aware that if I indulge in Anti-National Activities contrary to the provisions of acts and laws enforced by the Govt. and any such activity contrary
to rules and disciplinary norms as stated above may result in disciplinary action without prior notice from Principal and that I may expelled from the
college due to the same.
11. I know that according to Maharashtra Prohibition of ragging Act 1999, ragging of any kind Physical or Mental within or outside the campus is strictly
prohibited by law. A student found and proved accused in the same will be debarred from the course and shall not be admitted in any educational
institution for a period of 5 years from the date of his dismissal. Convicted student may be punished with imprisonment for a term upto 2 years / or
penalty which may extend upto Ten Thousand Rupees
12. I am aware that it is mandatory to fill-in the online E-Scholarhsip / Freeship Form for the Reserved Category (SC/DT/NT/OBC/SBC) at
https://mahaeschol.maharashtra.gov.in/escholarship/login.aspx and for ST Category https://etribal.maharashtra.gov.in) and submit duly filled-in print
copy to the Students Section (Principal Office) within 15 days from the date of admission. Failing to do so, I am liable to pay the entire fees.
13. I shall open a Saving Bank Account in Union Bank of India, Sion branch and furnish the details of the Account Number, MICR CODE, NEFT CODE
within 15 days from the date of admission.
Place : Sion-Chunabhatti, Mumbai.
Date :
Signature of Father / Guardian
Name : _____________________
Signature of the Student
Name : ____________________________
IMPORTANT INSTRUCTIONS :
ORIGINALS SUBMITTED AT THE TIME OF ADMISSION WILL BE RETURNED TO THE STUDENT IN THE FINAL YEAR HENCE,
STUDENTS ARE REQUIRED TO MAINTAIN SUFFICIENT ATTESTED COPIES OF ALL THE DOCUMENTS. NO STUDENT WILL BE
ENTERTAINED FOR PHOTOCOPIES.
10. DETAILS OF DOCUMENTS TO BE ATTACHED WITH THE APPLICATION FORM : (The Documents to be attached in the following order)
Sr. No.
Name of the document
Required Documents
Attached Documents
Original
Attested
Original
Attested
Photocopy
Photocopy
1
CAP Allotment Letter(Downloaded from DTE Website)
1
4
2
Certificate of Marks in S.S.C. / Equivalent Examination
1
4
3
Certificates of Marks obtained at the qualifying examination (Diploma / Equivalent) of all
1
4
Semesters (I to VI/VIII) having passed (ATKT mark sheet not required)
4
School / Institution Leaving / Transfer Certificate from institution last attended
1
4
5
Provisional Passing Certificate of qualifying examination.
1
4
6
Board Passing Certificate of Qualifying Examination
1
4
7
Equivalence Certificate from M.S.B.T.E.
1
4
8
Migration Certificate - only in case from SNDT/BATU/Govt.Poly.(Other than Mumbai)
1
4
9
GAP Certificate (if passed Diploma before 2014) duly notarized on Rs.100/- non-judicial
1
4
stamp paper
10
Indian Nationality Certificate (if Nationality Certificate not available any one of the
1
4
following document is required 1.L.C. 2. Domicile 3. Birth Certificate stating his
nationality as Indian)
11
1
-Online Registration of University Application for Provisional Statement of Eligibility
Form with Rs.320/- receipt and list of documents mentioned along with the form.
12
Relevant Colour Photographs Size 3”x3” (write name / year /branch /I.D.No. behind each)
6
For Backward Class Candidates only (In addition to the documents mentioned in Sr. No. 1 to 12)
13
Caste Certificate issued from an Executive Magistrate in Maharashtra State
1
4
14
Caste Validity Certificate issued by the Director of Social Welfare Pune (M.S.) or Scrutiny
1
4
Committee M.S.
15
Non-Creamy Layer Certificate valid for the current year (i.e. issued after 1 st April, 2014
1
4
valid upto 31st March, 2015) for NTA, NTB, NTC, NTD, VJ, DT, SBC and OBC Students
only.
16
Ration Card
4
17
Aadhar Card
4
Other Documents (In addition to the documents mentioned in Sr.No.1 to 12)
18
Domicile Certificate of candidate (for Type A candidates) if Domicile Certificate is not
1
4
available then any one of the following document is required 1. Birth Certificate 2. L.C.
stating his place birth is from the Maha. State.
19
Domicile Certificate (For Type B candidates) indicating candidate / mother / father is
1
4
Domiciled in the Maharashtra State
20
For Type C Candidates certificate from the employer in the Pro forma A stating that
1
4
father / mother of the candidate who is Central Govt. / Govt. of India undertaking
employee is presently posted in / outside Maharashtra.
21
For Type D candidates certificate from the employer in the Pro forma B stating that
1
4
father / mother of the candidate who is a Maharashtra State Govt. / Maharashtra State
Govt. undertaking employee
22
For Physically Handicapped candidate (P1,P2,P3) Certificate in the Pro forma F/F1
1
4
and Domicile Certificate of candidate stating him as the domicile of Maharashtra.
I hereby certify that the total number of certificates attached to this application as detailed above is ___________________________________ (in number)
i.e. _________________ \(in words) and that the certificates which are not submitted by me are not relevant to my application.
Date : ________________
Signature of the Candidate
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------FOR OFFICE USE ONLY
College Fee Receipt No. _______________
Clerk
Student Section
Clerk
Scholarship
Amount __________________
Clerk
Accounts Section
Date ______________________
PRINCIPAL