Admission Brochure‐2015 “CCL‐KE‐LAL” Central Coalfields Limited (CCL) under its CSR initiative have been providing free educational support along with free boarding and lodging facility to 25 meritorious students every year under the scheme namely “CCL KE LAL “for grooming them for selection in competitive examination of engineering like IIT, NITs, etc. Out of 11 students selected under CCL KE LAL in the year 2012, 7 students have qualified for IIT Mains, 6 have qualified for VIT, Vellore while all of them have qualified for one or more reputed Engineering colleges like JCECE etc. CCL intends to scale up the scheme by providing financial and educational support to larger universe of poor but meritorious students belonging to rural background in project affected area of CCL to give them an equal opportunity to compete with intelligent students of urban background. Selection of 25 boys students will be done under this scheme for the year 2015‐16. The selection of the students will be from the following two groups: Group – I 15 boys students from PAPs/land outstees/ villagers within command areas of CCL/Children of wage board employees of CCL. However number of employee’s children will not exceed 3. Group – II 10 boys students from open group from state of Jharkhand i.e. from group other than mentioned in group‐I above. Eligibility Criteria: For appearing in screening test the following is to be fulfilled by candidates :  9 CGPA in class X Board Examination 2015 of CBSE or 85% marks in Jharkhand State Board of Examination 2015 or ICSE Board 2015. Selection Methodology : a) Screening test objective type followed by interview on same day. b) Separate merit list will be prepared for both groups as mentioned above. c) 60 top boys students from group – I and 40 top boys students from group – II will be selected on merit of screening test. d) A final merit list will be prepared after assigning weightage of 80% for objective test marks and 20% for interview test marks separately for both the groups and 15 top boys students from group‐I and 10 top students from group‐II will be finally selected. Test Centre for screening test and written examination: i. DAV Public School, Gandhinagar Colony, CCL, Ranchi. ii. DAV Public School, Bachra, CCL Piparwar. iii. DAV Public School,Dhori, Phusro (at Central Colony, near Chapri Rest House, CCL). iv. DAV Public School, Tapin, CCL, Charhi. v. DAV Public School, Sec‐IV, Bokaro. Date of Test: 12.06.2015 (Friday) Timing of Test: 10:00 AM to 1:00 PM Availability of Admission Form: Admission Form and Admission Brochure will be available from 31.05.2015 at the following CCL offices: a) SD&CSR Department; CCL Headquarters; Darbhanga House Ranchi, Jharkhand. b) Office of Staff Officer (P&A) of all areas/units of CCL.(Argada, Garka Sayal, B&K Area, CRS Barkakana, Dhori, Kuju, Charhi, Rajrappa, Kathara, NK Area, Magadh & Amrapali, Piparwar, Rajhara and Central Hospital Naisarai) c) OR may be downloaded from official web site of CCL‐http://www.ccl.gov.in Last date for submission of filled in admission form: 06.06.2015 (till 5:00 PM) at: a) SD&CSR Department; CCL Headquarters; Darbhanga House Ranchi, Jharkhand, OR b) Office of Staff Officer (P&A) of all areas of CCL at Argada, Barka Syal, B&K Area, CRS Barkakana, Dhori, Kuju, Charhi, Rajrappa, Kathara, NK Area, Magadh & Amrapali, Piparwar, Rajhara and Central Hospital Naisarai) Facilities to be provided to selected students: A) 15 boys students under Group – I i.e. PAPs/ land oustees/ villagers within command areas of CCL/employee ward will be provided free boarding and lodging (separate for boys and girls ), free coaching and other educational facilities and they will be admitted at DAV Gandhinagar CCL. B) 10 Boys Students under group – II i.e. open category will arrange their boarding and lodging facilities and school admission fee at their own cost. However they will be provided free coaching facilities. NOTE : 1. Students should carry their class Xth Admit card, Blue/Black ball pen, pencil and other materials for appearing in the examination. 2. For all purpose, decision of GM(SD&CSR), CCL Ranchi will be considered as final decision. Contact for Enquiry: SD&CSR Department: 0651‐2365580/0651‐2360500/8987787619/8521331201 CCL‐KE‐LAL ADMISSION FORM 2015 (For official use only) Registration No Allotted‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Form Checked By‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐Signature‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐Date‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Please fill this Form with a Black/Blue ball point pen in BLOCK Letters only. 1. Details about the Student: a) Name of the Student ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ b) Father’s Name ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ c) Mother’s Name‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ d) Date of Birth‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐(DD/MM/YYYY) e) Name of the board _____________________________ f) Overall %age /CGPA obtained in Class X________ g) Year of passing ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ (Duly attested copy of Mark Sheet and Admit card of X Board Exam to be attached) 2. Test Centre Preference {Please tick( )}: DAV Public School, Gandhinagar, CCL, Ranchi. DAV Public School, Bachra, Piparwar. DAV Public School,Dhori. DAV Public School Tapin, Charhi. DAV Public School Sec‐IV, Bokaro. 3. Applied for Group‐I Group‐II 4. Communication Details: a) Mobile No. b) Alternative Mobile No.‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ c) Correspondence Address ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐PIN‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Tel. No. (with STD code)‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 5. Details about parents: Particulars Father Mother Name Occupation Designation Company/Area Name Mobile No. Certificate (For Group‐I only) This is to certify that the above applicant belongs to PAPs/ Land oustees/villagers within Command areas of CCL/Children of employee of ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Project. He is resident of ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Village which is within 25Km. Radius Of ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Project. Signature of PO/SO (P&A) with official seal Declaration by the Student/Parent/Guardian I/We hereby declare that the information furnished on this Application Form is correct to the best of my knowledge and belief. I understand that if any wrong information will be detected in future, the facility provided by CCL will be terminated forthwith and legal action can be taken against them. I have attached the attested copy of following documents to this application:‐ a. Mark sheet of Class X Board. b. Admit Card of Xth Board Exam. ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ (Signature of Student) (Signature of Parent/Guardian) Note: Incomplete admission form will not be accepted. ___________________________________________________________________________