r recognition m - pbte
TRANSCRIPT
Recognition Formwww.pbte.edu.pk
Institute or College
Telephone No
Bank Receipt Number & Date (to be pasted on the back page)
No of Technology/ Courses applied for
Signature of Incharge Recognition Section
Signature of Incharge Recognition Section
Office Diary #
Office Diary #
Acknowledgment Acknowledgment Received Registration & A ffiliation FormReceived Registration & A ffiliation Form
Easy to Register. Easy to Recognize.Easy to Register. Easy to Recognize.
Designed & Printed By Jawaria Qazi ,Recognition Section,PBTE Lahore
Date
Date
Name of the Institution
Telephone Fax e-mail address
Name & Address of Principal
Telephone Fax e-mail address
IT IS MANDATORY TO ANSWER ALL QUESTIONS BELOWIT IS MANDATORY TO ANSWER ALL QUESTIONS BELOW
1 Session for which it is desired to start classesSession for which it is desired to start classes
2 Technology / course for which Registration/ Affiliation is applied for.Technology / course for which Registration/ Affiliation is applied for.
03 27DAE Auto Farm DAE Textile Dy.Printing 02 26DAE Auto Diesel DAE Textile Weaving
05 29DAE Chemical DAE Weld & Steel Metal 06 30DAE Ch.Processing DAE Telecommunication 07 31DAE Civil Dip. In Commerce
3 TEVTA Registration InformationTEVTA Registration Information
04 28DAE Automation DAE Glass&Ceramics
08 32DAE Computer Dip. In Business Admin 09 33DAE Cmp.Information Certificate In Voc.Girls
01 DAE Architecture 25 DAE Textile Spining
10 34DAE Electrical Dip. In Voc.Girls 11 35
3612 DAE Electronics DDM
15 DAE Instrument 14 DAE Foundry & Pattern
17 DAE Mechanical 18 DAE Metallurgy & Weld 19 DAE Mine Electrical
16 DAE Leather
13 DAE Food
DAE Printing & Gr.Arts DAE Refrigeration& AC
Date of Submission
Registration & Recognition FormRegistration & Recognition Form
00260026 02290229 0229022912/02/200312/02/2003 02/02/200402/02/2004 02/02/200402/02/20042525 2525 252522 22 2222 22 22
Alert :-Last date for submission of application for Registration / Recognition of Institute / Technology of the year in which it is desired to start classes - 28 or 29 Feb
(For already registered Institutions)
Page-2
33 Certificate In Voc.Girls
34 Dip. In Voc.Girls
36 Other
6 Name & Address of The Manager/Secretary of Managing BodyName & Address of The Manager/Secretary of Managing Body
4 Is the institute under the management of a regular continued governing body which is registered with registrar & regularly functioning
Is the institute under the management of a regular continued governing body which is registered with registrar & regularly functioning
YES
5 Is the Head of the Institution a member of the Managing BodyIs the Head of the Institution a member of the Managing Body YES
Under & With
7 AttachedAttached
YES YES
a) A list of members of Managing Body b) A copy of the constitution.
1st1st 2nd2nd 3rd3rd
Page-3
STAFF
ENDOWMENT FUND
8 Has the staff statement showing their qualifications & number ? On prescribed form been attached? Has the staff statement showing their qualifications & number ? On prescribed form been attached?
YES NO
9 If no statement has been supplied, what staff does the institution propose to appoint? If no statement has been supplied, what staff does the institution propose to appoint?
10 Are the teachers employed on written agreement?Are the teachers employed on written agreement? YES (Attach a copy of agreement)
13
14
What is the percentage of contribution made by the institution towards provident fund? What is the percentage of contribution made by the institution towards provident fund?
Are there any service rules?Are there any service rules? YES
12 Does the institution maintain provident fund or pension (or both) for teachers? Does the institution maintain provident fund or pension (or both) for teachers?
YES
NO
11 Are the teachers paid the salary & allowances prescribed by the government institutes if not what salaries allowances are being paid?
Are the teachers paid the salary & allowances prescribed by the government institutes if not what salaries allowances are being paid?
YES NO
(Not applicable for Govt. Institutions)
15 Does the institution poses the required amount of endowment fund and this fund will be available in the shape DSC when required by PBTE
Does the institution poses the required amount of endowment fund and this fund will be available in the shape DSC when required by PBTE
YES
16 Quote the Name of Bank, Account Number and Available AmountQuote the Name of Bank, Account Number and Available Amount YES NO
(Attach a copy)
(Attach Bank Statement)
Rs. 95,000/- for DAE course per technology Rs.75,000/- for D.Com / D.B.A course
Rs.25,000/- for 2 years Vocational courses
Rs.10,000/- for 1 year and less course offered by the institution.
The new rates approved by the Board are as follows
Page-4
INCOME & EXPENDITURE
What are the income sources of the institution.What are the income sources of the institution.
a) Annual Income from investment and property
b) Annual Income from fixed deposits
c) Expected Annual income from fees.
d) Any other source
TOTAL:-
How has the expected annual income from fee been worked out?How has the expected annual income from fee been worked out?
What is the estimated annual total expenditure of the institution?What is the estimated annual total expenditure of the institution?
Do the income & expenditure balance If not how does the institution propose to balance itDo the income & expenditure balance If not how does the institution propose to balance it
How has the expected annual income from fee been worked out?How has the expected annual income from fee been worked out?
BUILDINGS:
Rs
17
18
19
20
Does the institution posses its own buildings?Does the institution posses its own buildings?
Has the Institution submitted the plan of the building?Has the Institution submitted the plan of the building? YES
NO
Are the building acquired on long lease If so a copy of lease be attach Are the building acquired on long lease If so a copy of lease be attach
YES NO
RequirementsRequirements Class rooms 9 sq.ft per student
Number of Class Rooms : One room for each class or a section of a class in addition to separate rooms in subjects in which practical work is conducted.
Page-5
b) Incase of rented building attach rent deed
Is there a Hall room for holding meetings / examinations?Is there a Hall room for holding meetings / examinations? YES NO24
What is the size of each class room?What is the size of each class room? (Attach a suite able map)27
Is there a properly staff room?Is there a properly staff room? YES NO28
Is the Head of the Institution residing in or near the premises of the institution Is the Head of the Institution residing in or near the premises of the institution
Are the lecture rooms commodious and well ventilatedAre the lecture rooms commodious and well ventilated
Are sanitary conditions satisfactoryAre sanitary conditions satisfactory
Are the surroundings satisfactory?Are the surroundings satisfactory?
YES
YES
YES
YES
NO
NO
NO
NO
Are the building fitted with electric lights / fans /air conditioners (optional)? Are the building fitted with electric lights / fans /air conditioners (optional)?
YES29
30
31
32
33
Page-6
What is the maximum number of classes to be held at the same time? What is the maximum number of classes to be held at the same time?
What is the proposed maximum strength of a section?What is the proposed maximum strength of a section?
25
26
Available Length * Width=
1
2
3
Note:- All star( ) marked entries will be filled by the Inspection Team
Attach Extra Chart incase of more class rooms
What is the size of each room?What is the size of each room? (Attach a suite able map)36
HOSTEL:
What provision has been made for the residence of studentsWhat provision has been made for the residence of students
What is the maximum number of boarders who can be lodged in the hostel?What is the maximum number of boarders who can be lodged in the hostel?
34
35
Is there a common room?Is there a common room?
What is the arrangement for medical aid?What is the arrangement for medical aid?
What are the qualifications of the Superintendent/Warden?What are the qualifications of the Superintendent/Warden?
Does the Superintendent/ Warden reside inside or near the hostelDoes the Superintendent/ Warden reside inside or near the hostel
YES
Does the institution possess play grounds?Does the institution possess play grounds?
Are the play grounds near the institution or hostel?Are the play grounds near the institution or hostel?
For what games have the institution made provision?For what games have the institution made provision?
YES
YES
NO
NO
41
42
43
Page-7
Available Length * Width=
1
2
3
Note:- All star( ) marked entries will be filled by the Inspection Team
Attach Extra Chart incase of more rooms
LIBRARY:
What amount is proposed to spend on the library?What amount is proposed to spend on the library?
What technical journals, Books relevant to the courses & newspapers are proposed to be subscribed What technical journals, Books relevant to the courses & newspapers are proposed to be subscribed
How many students can be accommodated in the reading room?How many students can be accommodated in the reading room?
What is the total number of books in the library?What is the total number of books in the library?
What is the size of Library?What is the size of Library?
Has the institution employed a whole time Physical Instructor.Has the institution employed a whole time Physical Instructor.
What are the qualifications of the Physical Instructor?What are the qualifications of the Physical Instructor?
YES44
45
What are the arrangements for Physio Medical Examination of students?What are the arrangements for Physio Medical Examination of students?46
Is there a Gymnasium & Provision for Athletics?Is there a Gymnasium & Provision for Athletics? YES NO
NO
47
48
49
50
51
52
53
General Reference 5 to 10 per cent Social Sciences 5 to 10 per cent Applied Sciences/Technology 60 to 70 per cent Fine Arts 2 to 4 per cent Literature 5 to 10 per cent Geography and Travel 5 to 10 per cent History and Biography 5 to 10 per cent Fiction 3 to 7 per cent
The following percentage of books may serve as suggestions for building up the Library of the Institution: The following percentage of books may serve as suggestions for building up the Library of the Institution:
Initial Recurring
Rs.____________ Rs.____________
Has a librarian been employeed and what are his qualificationsHas a librarian been employeed and what are his qualifications YES
Qualifications
Page-8
3 years Diploma Courses3 years Diploma Courses
What is the size of each Laboratory / Workshop?What is the size of each Laboratory / Workshop?54
Lab / Wksp 1st Year
Available Length * Width=
Attach Extra Chart incase of more lab/ workshops
Physics
Chemistry
Drawing
Available Length * Width=
Page-9
Lab / Wksp 3rd Year
Available Length * Width=
Lab / Wksp 1st Year
Available Length * Width=
Lab / Wksp 2nd Year
Available Length * Width=
Page-10
Amount Provided for purchase of equipment /Consumables
Amount Provided for purchase of equipment /Consumables
Amount Provided for purchase of equipment /Consumables
Lab / Wksp Required 15 sqft per student *No. Of applied strength
Attach Extra Chart incase of more lab/ workshops
Up to One year Diploma / Certificate Courses
Available Length * Width=
FURNITURE & EQUIPMENT:
What amount is proposed to be spent on furniture?What amount is proposed to be spent on furniture?
What amount is proposed to be spent on equipment?What amount is proposed to be spent on equipment?
Initial
Initial
Recurring
Recurring56
55
Rs._______
Rs._______
Rs._______
Rs._______
TUITION FEE
OFFICE ESTABLISHMENT
What is the tuition fee per student per month for each class?What is the tuition fee per student per month for each class?
What is the number of clerks employed?What is the number of clerks employed?
What is the annual fee for games , union fund etc?What is the annual fee for games , union fund etc?
How have the duties been allocated?How have the duties been allocated?
57
58
59
60
Page-11
8
1
2
3
4
5
6
7
A LIST OF MEMBERS OF MANAGING BODYA LIST OF MEMBERS OF MANAGING BODY
Copy of the registration certificate of the managing body with the registrar & with the Director Technical Education Copy of the registration certificate of the managing body with the registrar & with the Director Technical Education
A copy of constitution of managing bodyA copy of constitution of managing body
Copy of rules appointments salary leave etc. Members of teachings & clerical staff. Copy of rules appointments salary leave etc. Members of teachings & clerical staff.
Staff statement on prescribed formStaff statement on prescribed form
Fixed deposit receipt.Fixed deposit receipt.
Deed of ownership of the land or a copy of lease of building.Deed of ownership of the land or a copy of lease of building.
Report on the library on prescribed formReport on the library on prescribed form
Note: Government managed institutes will not be required to submit documents No 1,2,3,4 & 6
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Staff StatementStaff Statement Sr# Name Age Date of
Apt in the institute
Qualifications Is the already
Need not be filled in already approved
Degree Sub YR LIV Universty/Board
Page-13
CERTIFIED That the facts stated above are true to the best of my knowledgeThat the facts stated above are true to the best of my knowledge
Name of PrincipalName of Principal
SignatureSignature
Name of InstitutionName of Institution
The management has agreed to abide by regulations & rules of the Board.The management has agreed to abide by regulations & rules of the Board.
I) II)
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Member-5
Member-4
Page-16
Page 3
7: 7: 7: 7: 7: 7: 7
8: 8: 8: 8: 8: 8:
9: 9: 9: 9:
11: 11: 11:
14: 14: 14: 14: 14: 14: 14
15: 15: 15: 1
18: 18: 18: 18: 1
19: 19: 19:
Institute or College
Telephone No
Bank Receipt Number & Date (to be pasted on the back page)
No of Technology/ Courses applied for
Signature of Incharge Recognition Section
Signature of Incharge Recognition Section
Office Diary #
Office Diary #
Acknowledgment Acknowledgment Received Registration & A ffiliation FormReceived Registration & A ffiliation Form
Easy to Register. Easy to Recognize.Easy to Register. Easy to Recognize.
Designed & Printed By Jawaria Qazi ,Recognition Section,PBTE Lahore
Date
Date
Name of the Institution
Telephone Fax e-mail address
Name & Address of Principal
Telephone Fax e-mail address
IT IS MANDATORY TO ANSWER ALL QUESTIONS BELOWIT IS MANDATORY TO ANSWER ALL QUESTIONS BELOW
1 Session for which it is desired to start classesSession for which it is desired to start classes
2 Technology / course for which Registration/ Affiliation is applied for.Technology / course for which Registration/ Affiliation is applied for.
03 27DAE Auto Farm DAE Textile Dy.Printing 02 26DAE Auto Diesel DAE Textile Weaving
05 29DAE Chemical DAE Weld & Steel Metal 06 30DAE Ch.Processing DAE Telecommunication 07 31DAE Civil Dip. In Commerce
3 TEVTA Registration InformationTEVTA Registration Information
04 28DAE Automation DAE Glass&Ceramics
08 32DAE Computer Dip. In Business Admin 09 33DAE Cmp.Information Certificate In Voc.Girls
01 DAE Architecture 25 DAE Textile Spining
10 34DAE Electrical Dip. In Voc.Girls 11 35
3612 DAE Electronics DDM
15 DAE Instrument 14 DAE Foundry & Pattern
17 DAE Mechanical 18 DAE Metallurgy & Weld 19 DAE Mine Electrical
16 DAE Leather
13 DAE Food
DAE Printing & Gr.Arts DAE Refrigeration& AC
Date of Submission
Registration & Recognition FormRegistration & Recognition Form
00260026 02290229 0229022912/02/200312/02/2003 02/02/200402/02/2004 02/02/200402/02/20042525 2525 252522 22 2222 22 22
Alert :-Last date for submission of application for Registration / Recognition of Institute / Technology of the year in which it is desired to start classes - 28 or 29 Feb
(For already registered Institutions)
Page-2
33 Certificate In Voc.Girls
34 Dip. In Voc.Girls
36 Other
6 Name & Address of The Manager/Secretary of Managing BodyName & Address of The Manager/Secretary of Managing Body
4 Is the institute under the management of a regular continued governing body which is registered with registrar & regularly functioning
Is the institute under the management of a regular continued governing body which is registered with registrar & regularly functioning
YES
5 Is the Head of the Institution a member of the Managing BodyIs the Head of the Institution a member of the Managing Body YES
Under & With
7 AttachedAttached
YES YES
a) A list of members of Managing Body b) A copy of the constitution.
1st1st 2nd2nd 3rd3rd
Page-3
STAFF
ENDOWMENT FUND
8 Has the staff statement showing their qualifications & number ? On prescribed form been attached? Has the staff statement showing their qualifications & number ? On prescribed form been attached?
YES NO
9 If no statement has been supplied, what staff does the institution propose to appoint? If no statement has been supplied, what staff does the institution propose to appoint?
10 Are the teachers employed on written agreement?Are the teachers employed on written agreement? YES (Attach a copy of agreement)
13
14
What is the percentage of contribution made by the institution towards provident fund? What is the percentage of contribution made by the institution towards provident fund?
Are there any service rules?Are there any service rules? YES
12 Does the institution maintain provident fund or pension (or both) for teachers? Does the institution maintain provident fund or pension (or both) for teachers?
YES
NO
11 Are the teachers paid the salary & allowances prescribed by the government institutes if not what salaries allowances are being paid?
Are the teachers paid the salary & allowances prescribed by the government institutes if not what salaries allowances are being paid?
YES NO
(Not applicable for Govt. Institutions)
15 Does the institution poses the required amount of endowment fund and this fund will be available in the shape DSC when required by PBTE
Does the institution poses the required amount of endowment fund and this fund will be available in the shape DSC when required by PBTE
YES
16 Quote the Name of Bank, Account Number and Available AmountQuote the Name of Bank, Account Number and Available Amount YES NO
(Attach a copy)
(Attach Bank Statement)
Rs. 95,000/- for DAE course per technology Rs.75,000/- for D.Com / D.B.A course
Rs.25,000/- for 2 years Vocational courses
Rs.10,000/- for 1 year and less course offered by the institution.
The new rates approved by the Board are as follows
Page-4
INCOME & EXPENDITURE
What are the income sources of the institution.What are the income sources of the institution.
a) Annual Income from investment and property
b) Annual Income from fixed deposits
c) Expected Annual income from fees.
d) Any other source
TOTAL:-
How has the expected annual income from fee been worked out?How has the expected annual income from fee been worked out?
What is the estimated annual total expenditure of the institution?What is the estimated annual total expenditure of the institution?
Do the income & expenditure balance If not how does the institution propose to balance itDo the income & expenditure balance If not how does the institution propose to balance it
How has the expected annual income from fee been worked out?How has the expected annual income from fee been worked out?
BUILDINGS:
Rs
17
18
19
20
Does the institution posses its own buildings?Does the institution posses its own buildings?
Has the Institution submitted the plan of the building?Has the Institution submitted the plan of the building? YES
NO
Are the building acquired on long lease If so a copy of lease be attach Are the building acquired on long lease If so a copy of lease be attach
YES NO
RequirementsRequirements Class rooms 9 sq.ft per student
Number of Class Rooms : One room for each class or a section of a class in addition to separate rooms in subjects in which practical work is conducted.
Page-5
b) Incase of rented building attach rent deed
Is there a Hall room for holding meetings / examinations?Is there a Hall room for holding meetings / examinations? YES NO24
What is the size of each class room?What is the size of each class room? (Attach a suite able map)27
Is there a properly staff room?Is there a properly staff room? YES NO28
Is the Head of the Institution residing in or near the premises of the institution Is the Head of the Institution residing in or near the premises of the institution
Are the lecture rooms commodious and well ventilatedAre the lecture rooms commodious and well ventilated
Are sanitary conditions satisfactoryAre sanitary conditions satisfactory
Are the surroundings satisfactory?Are the surroundings satisfactory?
YES
YES
YES
YES
NO
NO
NO
NO
Are the building fitted with electric lights / fans /air conditioners (optional)? Are the building fitted with electric lights / fans /air conditioners (optional)?
YES29
30
31
32
33
Page-6
What is the maximum number of classes to be held at the same time? What is the maximum number of classes to be held at the same time?
What is the proposed maximum strength of a section?What is the proposed maximum strength of a section?
25
26
Available Length * Width=
1
2
3
Note:- All star( ) marked entries will be filled by the Inspection Team
Attach Extra Chart incase of more class rooms
What is the size of each room?What is the size of each room? (Attach a suite able map)36
HOSTEL:
What provision has been made for the residence of studentsWhat provision has been made for the residence of students
What is the maximum number of boarders who can be lodged in the hostel?What is the maximum number of boarders who can be lodged in the hostel?
34
35
Is there a common room?Is there a common room?
What is the arrangement for medical aid?What is the arrangement for medical aid?
What are the qualifications of the Superintendent/Warden?What are the qualifications of the Superintendent/Warden?
Does the Superintendent/ Warden reside inside or near the hostelDoes the Superintendent/ Warden reside inside or near the hostel
YES
Does the institution possess play grounds?Does the institution possess play grounds?
Are the play grounds near the institution or hostel?Are the play grounds near the institution or hostel?
For what games have the institution made provision?For what games have the institution made provision?
YES
YES
NO
NO
41
42
43
Page-7
Available Length * Width=
1
2
3
Note:- All star( ) marked entries will be filled by the Inspection Team
Attach Extra Chart incase of more rooms
LIBRARY:
What amount is proposed to spend on the library?What amount is proposed to spend on the library?
What technical journals, Books relevant to the courses & newspapers are proposed to be subscribed What technical journals, Books relevant to the courses & newspapers are proposed to be subscribed
How many students can be accommodated in the reading room?How many students can be accommodated in the reading room?
What is the total number of books in the library?What is the total number of books in the library?
What is the size of Library?What is the size of Library?
Has the institution employed a whole time Physical Instructor.Has the institution employed a whole time Physical Instructor.
What are the qualifications of the Physical Instructor?What are the qualifications of the Physical Instructor?
YES44
45
What are the arrangements for Physio Medical Examination of students?What are the arrangements for Physio Medical Examination of students?46
Is there a Gymnasium & Provision for Athletics?Is there a Gymnasium & Provision for Athletics? YES NO
NO
47
48
49
50
51
52
53
General Reference 5 to 10 per cent Social Sciences 5 to 10 per cent Applied Sciences/Technology 60 to 70 per cent Fine Arts 2 to 4 per cent Literature 5 to 10 per cent Geography and Travel 5 to 10 per cent History and Biography 5 to 10 per cent Fiction 3 to 7 per cent
The following percentage of books may serve as suggestions for building up the Library of the Institution: The following percentage of books may serve as suggestions for building up the Library of the Institution:
Initial Recurring
Rs.____________ Rs.____________
Has a librarian been employeed and what are his qualificationsHas a librarian been employeed and what are his qualifications YES
Qualifications
Page-8
3 years Diploma Courses3 years Diploma Courses
What is the size of each Laboratory / Workshop?What is the size of each Laboratory / Workshop?54
Lab / Wksp 1st Year
Available Length * Width=
Attach Extra Chart incase of more lab/ workshops
Physics
Chemistry
Drawing
Available Length * Width=
Page-9
Lab / Wksp 3rd Year
Available Length * Width=
Lab / Wksp 1st Year
Available Length * Width=
Lab / Wksp 2nd Year
Available Length * Width=
Page-10
Amount Provided for purchase of equipment /Consumables
Amount Provided for purchase of equipment /Consumables
Amount Provided for purchase of equipment /Consumables
Lab / Wksp Required 15 sqft per student *No. Of applied strength
Attach Extra Chart incase of more lab/ workshops
Up to One year Diploma / Certificate Courses
Available Length * Width=
FURNITURE & EQUIPMENT:
What amount is proposed to be spent on furniture?What amount is proposed to be spent on furniture?
What amount is proposed to be spent on equipment?What amount is proposed to be spent on equipment?
Initial
Initial
Recurring
Recurring56
55
Rs._______
Rs._______
Rs._______
Rs._______
TUITION FEE
OFFICE ESTABLISHMENT
What is the tuition fee per student per month for each class?What is the tuition fee per student per month for each class?
What is the number of clerks employed?What is the number of clerks employed?
What is the annual fee for games , union fund etc?What is the annual fee for games , union fund etc?
How have the duties been allocated?How have the duties been allocated?
57
58
59
60
Page-11
8
1
2
3
4
5
6
7
A LIST OF MEMBERS OF MANAGING BODYA LIST OF MEMBERS OF MANAGING BODY
Copy of the registration certificate of the managing body with the registrar & with the Director Technical Education Copy of the registration certificate of the managing body with the registrar & with the Director Technical Education
A copy of constitution of managing bodyA copy of constitution of managing body
Copy of rules appointments salary leave etc. Members of teachings & clerical staff. Copy of rules appointments salary leave etc. Members of teachings & clerical staff.
Staff statement on prescribed formStaff statement on prescribed form
Fixed deposit receipt.Fixed deposit receipt.
Deed of ownership of the land or a copy of lease of building.Deed of ownership of the land or a copy of lease of building.
Report on the library on prescribed formReport on the library on prescribed form
Note: Government managed institutes will not be required to submit documents No 1,2,3,4 & 6
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Attach as an Annexure ( )
Staff StatementStaff Statement Sr# Name Age Date of
Apt in the institute
Qualifications Is the already
Need not be filled in already approved
Degree Sub YR LIV Universty/Board
Page-13
CERTIFIED That the facts stated above are true to the best of my knowledgeThat the facts stated above are true to the best of my knowledge
Name of PrincipalName of Principal
SignatureSignature
Name of InstitutionName of Institution
The management has agreed to abide by regulations & rules of the Board.The management has agreed to abide by regulations & rules of the Board.
I) II)
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Name & Signature with Date
Member-5
Member-4
Page-16
Page 3
7: 7: 7: 7: 7: 7: 7
8: 8: 8: 8: 8: 8:
9: 9: 9: 9:
11: 11: 11:
14: 14: 14: 14: 14: 14: 14
15: 15: 15: 1
18: 18: 18: 18: 1
19: 19: 19: