Application No.
(for office use only)
APPLICATION FORM
2016-2017
[FULL TIME GENERAL / 1st SHIFT ONLY]
FOR SEEKING AFFILIATION FOR NEW
POLYTECHNIC COLLEGES /
HOTEL MANAGEMENT AND CATERING TECHNOLOGY
INSTITUTIONS FOR THE
ACADEMIC YEAR 2016-2017
UNDER FULL TIME GENERAL / FIRST SHIFT ONLY
Name of the Trust / Society
Name of the Institution
District
Category [Polytechnic/HMCT]
Mode
:
:
:
:
: FULL TIME GENERAL / 1st SHIFT
Submitted to
The Director of Technical Education,
53, Sardar Patel Road,
Guindy,
Chennai - 600 025.
Telephone Nos. 22351018 / 22350525
APPLICATION No.
(for Office use)
Date of Submission of the Application
--
--
APPLICATION FORM
APPLICATION FOR SEEKING AFFILIATION FOR THE NEW POLYTECHNIC COLLEGES / HOTEL
MANAGEMENT AND CATERING TECHNOLOGY INSTITUTION FOR THE ACADEMIC YEAR 2016-2017
UNDER FULL TIME - GENERAL / FIRST SHIFT PROGRAMME ONLY
REGISTRATION FEE :
S.No
Demand Draft No.
Demand Draft Date
Bank
Amount
Rs. 5,000
Registration Fee
:
` Rs.5,000
Demand Draft drawn in favour of "Director of Technical Education, Chennai" payable at
Chennai should be enclosed.
01.
NAME AND ADDRESS OF THE SOCIETY / TRUST / COMPANY ESTABLISHED UNDER
SECTION 25 OF COMPANIES ACT 1956
Name of the Trust / Society / Company
Address of the Trust / Society / Company
2016 - 2017
Village / Town
Taluk
District
Pincode
Assembly Constituency
Parliament Constituency
Phone
STD Code:
Phone No.:
Fax
STD Code:
Fax No.:
Mobile
E-mail
2|Page
02 (a)
NAME AND ADDRESS OF THE INSTITUTION AT THE PERMANENT SITE
Name of the Institution
Address of the Institution
Village / Town :
Taluk :
District :
Pincode :
Assembly Constituency :
Parliament Constituency :
Phone : STD Code:
Phone No.:
Fax : STD Code:
Fax No.:
Mobile :
E-mail :
02 (b)
DETAILS OF THE SOCIETY / TRUST / COMPANY
Society Registration Act No. or Trust Act No.
or Company Act No.
Registration No.
Date of Registration
Place of Registration
02 (c)
S.No
DETAILS OF MEMBERS / TRUSTEES AND THEIR EXPERIENCE IN RUNNING HIGHER
EDUCATIONAL, TECHNICAL OR OTHER PROFESSIONAL INSTITUTIONS ETC.
Name of the Members of the
Trust / Society / Company
2016 - 2017
Designation
in the Trust /
Society /
Company
Qualification
Experience in running higher
educational, technical or other
professional institutions (in years)
3|Page
02 (d)
TRACK RECORD OF THE APPLICANT IN TERMS OF TECHNICAL / PROFESSIONAL /
NON-PROFESSIONAL INSTITUTIONS RUN / MANAGED BY THE SOCIETY/TRUST
Whether the Trust / Society / Company is
:
running/managing any educational institutions
Yes
No
If YES, then provide the information as per the table given below.
S.N
03.
Name and
Address of the
Institution
Year of
Establishment
Whether
Diploma/
Degree
(UG/PG)
Discipline
conducted
Duration
of the
Course
Annual
Intake
capacity
Whether
approved by
AICTE/Univ./
UGC/State
Govt./Board/
Other Council
DETAILS ABOUT THE CATEGORY OF THE INSTITUTION
Year of establishment
: 2016 - 2017
Category of the Institution
POLYTECHNIC COLLEGE
HOTEL MANAGEMENT & CATERING
TECHNOLOGY
(Please tick the appropriate box)
MINORITY
Linguistic
NONMINORITY
Malayalam
04.
Telugu
Religious
Sourashtra
Christian
Muslim
Others
(Specify)
Jain
PARTICULARS OF THE HEAD OF THE INSTITUTION [PRINCIPAL]
Name
Designation
Qualification
:
Mobile :
Phone : STD :
Fax : STD :
Phone No.
Fax No.
E-mail :
2016 - 2017
4|Page
05.
DETAILS OF THE LANDS [PERMANENT SITE AS APPROVED BY AICTE]
Classification of the Permanent Site
Rural Area
Other than Rural area
(Please Click on any one of the classification)
:
Ownership of Land
Government
Trust
Society
Govt. Leased
Owned
Company
Details of Land
(The Survey No. with sub-division and extent of lands for each survey number to be indicated)
Sl.
No
.
Registration
Document No.
Registration
Date
Name of the
village
Survey No. with
sub-division
Extent of
Lands
(in acres)
Land
Classification
[Indicate Dry
or Wet Land]
TOTAL
Legal disputes , if any
On Land
YES
NO
On Trust
--YES
If YES, Details
LAND USE CONVERSION
CERTIFICATE Details
LAND USE CLASSIFICATION Details
06.(a)
Certificate No.:
Date:
Certificate No.:
Date:
DETAILS ABOUT THE BUILDING OF THE INSTITUTION AT THE PERMANENT SITE
Whether the Building Plan is approved by the
:
DTCP/competent authority
Yes
No
If YES, then
Name of the authority approved the building plan
Designation of the authority approved the building plan
Date of Approval
Proceedings Number issued by the authority
06 (b)
PHYSICAL INFRASTRUCTURE - COMPLETE DETAILS OF BUILT-UP AREA (R.C.C.)
S.
No
Built-up (Carpet) Area
[in sq.m]
FIRST YEAR
Structure
(a)
Instructional area [INA]
R.C.C.
(b)
Administrative area [ADA]
R.C.C.
(c)
Amenities area [AMA]
R.C.C.
Required Area
(R.C.C.)
Available Area
(R.C.C.)
TOTAL AREA :
2016 - 2017
5|Page
NO
07.
DETAILS OF THE COURSES APPROVED BY AICTE
S.No
Discipline [Course Details]
01.
02.
03.
04.
05.
06.
General /
st
1 Shift
Mode
1st SHIFT
1st SHIFT
1st SHIFT
1st SHIFT
1st SHIFT
1st SHIFT
Full Time
Full Time
Full Time
Full Time
Full Time
Full Time
Approved Intake
for 2016-2017
AICTE Approval
Letter No. & Date
TOTAL ANNUAL INTAKE
08 (a)
S.No
NAME AND ADDRESS OF THE MEMBERS OF THE GOVERNING BODY AS PER THE
COMPOSITION PRESCRIBED BY AICTE
Name
Position
01.
Chairman
02.
Member
Secretary
Qualification
Present
Professional
position /
Occupation
Telephone
Numbers
E-mail
Address
03.
04.
05.
06.
07.
Members
08.
09.
10.
11.
08 (b)
S.No
NAME AND ADDRESS OF THE MEMBERS OF THE ANTI-RAGGING COMMITTEE AS PER
THE COMPOSITION PRESCRIBED BY AICTE
Name
Position
Qualification
Present
Professional
position /
Occupation
Telephone
Numbers
E-mail
Address
01.
02.
03.
2016 - 2017
6|Page
04.
05.
06.
07.
08.
09.
10.
09 (a)
S.
No
I.
PHYSICAL INFRASTRUCTURE - ONLY FOR FIRST YEAR (As per the details furnished in AICTE web
portal. Requirement as per AICTE application process hand book 2016-2017)
Category
Number
Required
Number
Available
Shortage
Built-up
Area
Required
Built-up
Area
Available
Shortag
e
AICTE NORMS
[AREA/ROOM]
INSTRUCTIONAL AREA
Diploma [Engg.]
1.
Class rooms [C]
1 class room for each
division of intake of
60 (66 sqm each)
2.
Tutorial rooms [D]
3.
Laboratory
4.
Workshop
200 sq.m
5.
Computer Centre
100 sq.m
6.
Drawing Hall
132 sq.m
7.
Library and
Reading Room
300 sq.m
II.
1 (33 sqm )
6 (66 sqm each)
01 No.
[200 sq.m]
01 No.
[100 sq.m]
01 No.
[132 sq.m]
01 No.
[300 sq.m]
ADMINISTRATIVE AREA
8.
Principal Office
30 sq.m
9.
Board room
20 sq.m
10.
College Office
11.
Faculty room
12.
Central Stores
30 sq.m
13.
Maintenance
10 sq.m
14.
Security
10 sq.m
15.
House keeping
10 sq.m
16.
Pantry for Staff
10 sq.m
17.
Exam. Office
30 sq.m
2016 - 2017
5sq.m
01 No.
[30 sq.m]
01 No.
[20 sq.m]
01 No.[150 sq.m
for one
programme]
Sanc.Intake [
F
20
F x 5 sq.m]
01 No.
[30 sq.m]
01 No.
[10 sq.m]
01 No.
[10 sq.m]
01 No.
[10 sq.m]
01 No.
[10 sq.m]
01 No.
[30 sq.m]
7|Page
III.
18.
19.
20.
21.
22.
23.
24.
AMENITIES AREA
Toilets
[Ladies]
Toilets
[Gents]
Boys Common
Room
Girls Common
Room
Cafeteria
75 sq.m
75 sq.m
01 No.
[75 sq.m]
01 No.
[75 sq.m]
01 No.
[150 sq.m]
01 No.
[10 sq.m]
01 No.
[10 sq.m]
75 sq.m
75 sq.m
150 sq.m
Stationary Store
& Reprography
First Aid cum Sick
Room
Adequate
[150 sq.m]
10 sq.m
10 sq.m
TOTAL
---
09 (b)
COMPUTER CENTRE - COMPUTERS, SOFTWARE, INTERNET AND PRINTERS
S.
No
Computer Facilities
1.
Computers [S] First Year Students only
2.
Multimedia Computers
Library / Internet Surfing in
Reading room
3.
Computers For Faculty Members
---
4.
Computers For Administrative Office
---
5.
Printers [P]
---
6.
Internet Facility
---
7.
LAN Facility
8.
Legal System Software
List of System Softwares
Sanctioned
intake
Number of Terminals
Required
Available Shortfall
AICTE NORMS
Sanc.Intake [ S.I]
6
[Min. 20 PCs]
1% of Total Students
Intake
[Max. 10]
S
YES / NO
Exclusive - along with LAN
and Internet over and above
the requirement meant for
students
S
10
S.I <=300 =16 Mbps
S.I >300 to 600 = 32
Mbps
P
All
---
03
---
20
(01).
(02).
(03).
9.
Legal Application Software
List of Application Software
10.
UPS
2016 - 2017
Number of UPS
Capacity
8|Page
11.
Computer Table / Chair
No. of Computer Tables :
No. of Computer Chairs :
12.
Air Conditioners
YES / NO
13.
Central Xerox Facility
YES / NO
14.
Mail Server & Client
YES / NO
15.
Computer Specifications
[General, in brief]
09.
(c)
BOOKS, JOURNALS AND LIBRARY FACILITIES:
No
Description
AICTE NORMS
Number of Titles
50 Titles of Books for whole first Year
Number of
Volumes
50 volumes of Books for each division
of 60 students
No. of Journals
1 Journal for each division of 60
students
09 d.
Required
Available
Shortage
GENERAL FACILITIES - ESSENTIAL REQUIREMENTS
S.
No
Description
1.
Language Laboratory
2.
Potable Water supply
3.
Electric supply
4.
Backup Electric supply
5.
Sewage Disposal
6.
Rain Water Harvesting and Solar Energy/ Power Systems
7.
Telephone and Fax
8.
Vehicle parking
9.
Institution Web-site
10.
Barrier Free built Environment for Differently-Abled and
elderly persons including availability of specially designed
toilets for ladies and gents separately.
11.
Safety provisions including fire and other calamities
12.
General Insurance provided for assets against fire,
burglary and other calamities
2016 - 2017
Availability
[YES / NO]
If YES, then
Number Available
9|Page
13.
Road Suitable for use by Motor Vehicle Motorised Road
14.
General Notice Board and Departmental Notice Boards
15.
First Aid, Medical and Counseling Facilities
16.
Appointment of Student Counselor
17.
Establishment of Anti Ragging Committee
18.
Establishment of Grievance Redressal Committee in the
Institute
19.
Establishment of Internal Complaint Committee
20.
Establishment of Committee for SC/ST
09.e GENERAL FACILITIES - DESIRABLE REQUIREMENTS
Public Announcement System at strategic locations
22.
Enterprise Resource Planning software for InstituteStudent-Parent Interaction
23.
Transport
24.
Post, Banking Facility, ATM
25.
CCTV Security System
26.
LCD Projector in class rooms
27.
Group Insurance to be provided for Employees
28.
Insurance for Students
29
Staff Quarters
30.
Strong Room [Storing QPs & ASs]
31.
Security arrangement [Day / Night]
32.
Sufficient halls for Examination
ACADEMIC INFRASTRUCTURE
1.
Class Room 1
2.
Class Room 2
3.
Class Room 3
4.
Class Room 4
5.
Class Room 5
2016 - 2017
Power
Connection (Y/N)
Ventilation (Y/N)
No. of Fans
No. of Lights
Teaching Aids
[BB / OHP / LCD]
Furniture (Nos)
Work Table (Nos)
Details to be provided, whichever necessary
Size [ l x b ]
Category
Available
S.
No
Required
AREA [sq.m]
Capacity
10.
21.
10 | P a g e
6.
Tutorial Room 1
7.
Tutorial Room 2
8.
Laboratory 1
9.
Laboratory 2
10.
Laboratory 3
11.
Laboratory 4
12.
Laboratory 5
13.
Laboratory 6
14.
Workshop
15.
Computer Centre
16.
Drawing Hall
17.
Library
18.
Reading Room in Library
19.
Principal Room
20.
Board Room
21.
College Office
22.
Faculty Room 1
23.
Faculty Room 2
24.
Faculty Room 3
25.
Faculty Room 4
26.
Faculty Room 5
27.
Central Stores
28.
Maintenance Room
29.
Security Room
30.
House Keeping Room
31.
Pantry for staff
32.
Exam Office
33.
Gents Toilet
34.
Ladies Toilet
35.
Boys Common Room
36.
Girls Common Room
37.
Cafeteria
38.
Stationary Store &
Reprography
39.
First Aid cum Sick Room
40.
TOTAL :
2016 - 2017
11 | P a g e
REQUIREMENT FOR FIRST YEAR ALL THE FACULTY & STAFF SHOULD BE ON PAY
ROLL.
Faculty for First year
: Faculty : Student Ratio = 1 : 20 must be computed based on
Sanctioned intake only.
Librarian
: One
Physical Education
Director
Technical Supporting Staff
: One
:
Workshop Instructor
Skilled / Lab Assistant :
Administrative Staff (As per
one
Minimum 3 for first year
: Minimum 3
Institutions requirement )
Basic servants (As per
: Minimum 4
Institutions requirement )
11 (a)
FIRST YEAR FACULTY AND STAFF REQUIREMENTS FOR SANCTIONED INTAKE OF
____________
S.No
First year
HOD
Lecturer
TOTAL
AICTE NORMS &
GUIDELINES
English
Faculty : Student
Ratio = 1 : 20
Mathematics
1.
Physics
Chemistry
Engineering
TOTAL
(i)
TOTAL SANCTIONED INTAKE
(ii)
TOTAL STAFF REQUIRED [at the ratio of 1 : 20]
(iii)
TOTAL STAFF AVAILABLE [ON THE PAY ROLL] -
(iv)
STAFF STUDENT RATIO [BASED ON PAYROLL] -
Requirement Of Principal, Librarian, Physical Education Director,
Non Teaching Technical And Others
Required
2.
Principal
ONE
3.
Librarian
ONE
4.
Physical Education Director
ONE
5.
Non-Teaching Technical Staff :
WORKSHOP INSTRUCTOR
: One
SKILLED / LAB ASSISTANTS (As per requirement)
: Minimum 1 for each lab.
UNSKILLED ASSISTANTS (As per requirement)
: As per requirement
6.
Number of Ministerial Staff
: Minimum 3
7.
Number of Basic Servants
: Minimum 4
8.
Whether AICTE Pay Scales implemented
: state YES / NO :
2016 - 2017
Available
12 | P a g e
Name of the
Faculty
Member with
Stamp Size
Photo
2016 - 2017
Total
emoluments
Institution
Present Basic
Pay
Teaching
Scale of Pay
Date of
Joining
Date of Birth &
Age
Years
Corresponding
Specialization
Position
Qualification
with Class
obtained
starting from
the highest
Degree
Institution
Department
Total
emoluments
Present Basic
Pay
Scale of Pay
Date of
Joining
Corresponding
Specialization
Qualification
with Class
obtained
starting from
the highest
Degree
Date of Birth &
Age
Stamp Size
Photo
Designation
11 (b)
FACULTY - QUALIFICATION AND EXPERIENCE
I. PRINCIPAL - QUALIFICATION
NAME OF THE PRINCIPAL :
Position
Signature
II. PRINCIPAL - EXPERIENCE
Industry
Years
III. TEACHING FACULTY - QUALIFICATION
Signature
13 | P a g e
IV. TEACHING FACULTY - EXPERIENCE
S.No
Name of the faculty
Member
Teaching
Institution
Position
Industry
Years
Institution
Position
Years
Total
emoluments
Present Basic
Pay
Scale of Pay
Date of
Joining
Date of Birth &
Age
Previous
Experience
Qualification
with Class
obtained
starting from
the highest
Degree
Signature
Physical
Education
Director
Librarian
Name of the
Faculty Member
with Stamp Size
Photo
Designation
V. LIBRARIAN AND PHYSICAL EDUCATION DIRECTOR
2016 - 2017
14 | P a g e
S.
No
Name of the Staff
S.
No
2016 - 2017
Date of Birth &
Age
Date of
Joining
Scale of Pay
Present Basic
Pay
Date of Birth &
Age
Date of
Joining
Scale of Pay
Present Basic
Pay
Signature
Previous
Experience
Previous
Experience
Signature
Qualification
Qualification
Total
emoluments
Designation
Designation
Total
emoluments
Laboratory
VII. MINISTERIAL STAFF
Place of Work
Name of the Staff
Department
VI. WORKSHOP AND TECHNICAL SUPPORTING STAFF
15 | P a g e
12 (a)
EQUIPMENTS
1.
Whether Equipments for all the Laboratories / Workshops prescribed
as per syllabus is available
YES / NO
2.
Whether all the existing equipments are entered in Stock Register ?
YES / NO
3.
Whether all the existing equipments are in working condition or not ?
YES / NO
4.
If not, list out the equipments that are not in working condition
(list to be enclosed)
5.
Whether any equipments are likely to be purchased in respect of the
Courses for which extension of approval is applied
YES / NO
6.
If YES, list out the equipments
(list to be enclosed)
12 (b)
LIST OF EQUIPMENTS AND ITS ADEQUACY [FOR A BATCH OF 30 STUDENTS]
I. FIRST SEMESTER ENGINEERING PHYSICS I PRACTICAL [ M SCHEME ]
S.
No
1.
2.
3.
4.
5.
6.
List of Equipments
MICROMETER
(SCREW
GAUGE) SETUP - Screw
gauge, graph sheet and
irregular glass plate.
VERNIER
CALIPERS
SETUP - Vernier Calipers
and Solid Cylinder
CONCURRENT
FORCES
SETUP - Vertical drawing
board, two Z pulleys, three
sets of slotted weights (5 x
50g) and twine thread
POISEUILLES
METHOD
SETUP - Burette stand,
graduated burette without
stopper,
rubber
tube,
beaker,
capillary
Tube,
digital stop watch and
funnel.
STOKES METHOD SETUP
Stokes Apparatus, high
viscous liquid (Castrol oil),
glass beads of Different
radii, digital stop watch and
screw gauge
SURFACE
TENSION
SETUP - Beaker with water,
capillary tube, iron stand
with
clamp,
pointer,
travelling microscope and
hydro static bench.
2016 - 2017
Quantity
Required
Quantity
Available
Adequate
or Not
If Not,
Whether
Order has
been placed?
If YES,
Purchase
Order
details
Remarks
4
SETS
4
SETS
4
SETS
4
SETS
4
SETS
4
SETS
16 | P a g e
7.
8.
SONOMETER SETUP Sonometer, screw gauge,
tuning fork, rubber hammer,
slotted weight hanger set (5
x 0.5kg) and paper rider
DEFLECTION
MAGNETOMETER SETUP Deflection
Magnetometer,
meter scale and two bar
magnets
4
SETS
4
SETS
II. SECOND SEMESTER ENGINEERING PHYSICS II PRACTICAL [ M SCHEME ]
S.
No
1.
2.
3.
4.
5.
6.
List of Equipments
Quantity
Required
REFRACTIVE
INDEX
SETUP
Travelling
Microscope, Beaker with
transparent liquid and Saw
dust
SPECTROMETER. SETUP Spectrometer,
Sodium
vapour lamp, Reading lens
and Glass prism
SOLAR CELL SETUP Solar cell Kit for drawing the
V - I characteristics
LAWS OF RESISTANCES Battery
Eliminator,
key,
rheostat,
ammeter,
voltmeter, Connecting wires
and two known standard
resistances
METRE BRIDGE SETUP Meter
Bridge,
variable
resistance box, Leclanche
cell, plug Key, galvanometer,
high
resistance,
jockey,
connecting
Wires
and
unknown resistance
POTENTIOMETER SETUP Potentiometer, two cells
(Leclanche cell and Daniel
cell),
Battery eliminator,
Rheostat, Key, two way key,
Galvanometer,
resistance,
jockey
connecting wires
2016 - 2017
Quantity
Available
Adequate
or Not
If Not,
Whether
Order has
been placed?
If YES,
Purchase
Order
details
Remarks
SETS
4
SETS
4
SETS
4
SETS
4
SETS
4
SETS
high
and
17 | P a g e
7.
8.
9.
10.
JOULES
CALORIMETER
SETUP- Joules Calorimeter,
Battery eliminator, Rheostat,
Key, Ammeter, voltmeter,
stop clock, thermometer,
digital
Balance
and
connecting wires
COPPER
VOLTAMETER
SETUP- Copper Voltameter,
Battery eliminator, Rheostat,
Key, Ammeter, stop clock,
digital balance, emery sheet
and Connecting wires
P-N JUNCTION DIODE
SETUP - P-N Junction Diode
forward characteristics kit
LOGIC GATES SETUP Logic
gates
testing
apparatus kit with bread
board for Mounting ICs and
Integrated circuit chips ( IC
7404 NOT Gate, IC 7408
AND Gate, IC 7432 OR
gate, IC 7400 NAND Gate,
IC 7402 NOR Gate)
4
SETS
4
SETS
4
SETS
4
SETS
III. I & II SEMESTER ENGINEERING CHEMISTRY I & II PRACTICAL [ M SCHEME ]
S.
No
List of Equipments
Quantity
Required
(in Nos)
Quantity
Available
Adequate
or Not
If Not,
Whether
Order has
been placed?
If YES,
Purchase
Order
details
Remarks
Non-Consumable Items:
gas
Connection
1.
Indane
(DBC)
2.
Exhaust Fan (High capacity)
3.
Fire Extinguisher
4.
First Aid Box (Full set)
5.
Safety chart
6.
Chemical Balance
7.
Fractional weight box
8.
PH meters
9.
Working Table
accessories
with
all
Sufficient
Glassware and Other Items :
1.
Burette 50ml
35
2.
Burette stand
35
3.
Pipette 20ml (with safety
35
2016 - 2017
18 | P a g e
bulb)
4.
Pipette 10ml
5.
Conical Flask 250ml
35
6.
Funnel 3 (Polythene)
50
7.
Porcelain Tile 6x6
35
8.
Measuring Cylinder 10ml
9.
Measuring Cylinder 1000ml
10.
Reagent
250ml
Bottle
(White)
60
11.
Reagent
125ml
Bottle
(White)
100
12.
Reagent
250ml
Bottle
(Amber)
80
13.
Test tubes 15 x 1.5 mm
1000
14.
Test tubes 15 x 2.5 mm
500
15.
Test tube stand
35
16.
Test tube holder
35
17.
Test tube cleaning brush
35
18.
Glass Trough
19.
Beakers 100 ml
35
20.
Glass Rods 15cm
100
21.
Watch Glass 3
35
22.
Wash Bottle
1000 ml
23.
Nickel Spatula
24.
Bunsen Burner
connection
25.
Plastic Buckets (15 lts)
10
26.
Tripod Stand (Iron)
30
27.
Filter Paper Round sheets
28.
Standard flask 100 ml
(Polythene)
35
35
for
gas
30
sufficien
t Nos.
35
IV. SECOND SEMESTER WORKSHOP PRACTICE [ M SCHEME ]
S.
No
List of Equipments
Quantity
Required
(in Nos)
Quantity
Available
Adequate
or Not
If Not,
Whether
Order has
been placed?
If YES,
Purchase
Order
details
Remarks
FITTING SECTION
1.
4 Bench vice
30
2.
12 Flat Rough file
30
2016 - 2017
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3.
12 Flat smooth file
30
4.
10 Try angular file
30
5.
8 Half round file
30
6.
8 Square file
30
7.
10 Round file
30
8.
150 mm Try square
30
9.
150 mm Steel rule
30
10.
6 mm Dot punch
30
11.
6 mm Center punch
30
12.
Hacksaw Frame
30
13.
6 leg vice
14.
6 mm Prick punch
15.
Hand shearing machine
16.
Ball Pan lbs Hammer
30
17.
6.8 mm Drill Bit
18.
8.5 mm Drill Bit
19.
10.2 mm Drill Bit
20.
M8 tap set
21.
M10 tap set
22.
M12 tap set
23.
Bench drilling machine
24.
Deep cut Hacksaw frame
25.
2 x 1 Surface plate
26.
Scriber
30
27.
Tap wrench
10
WIRING SECTION
1.
6 Insulated handle cutting
pliers
30
2.
8 Insulated handle screw
driver
30
3.
Pound hammer
30
4.
Wire Cutter
30
5.
250V Line Tester
30
6.
10 cm Poker
30
7.
4 Connecting Screw driver
30
8.
2 x 1 Wiring board
30
9.
Multi meter
10.
Required
numbers
of
switches
and
sufficient
consumables
Adeq
PLUMBING SECTION
2016 - 2017
20 | P a g e
1.
Hand operated bending Tool
2.
Sprit level
3.
Try Square
4.
Measuring Tape
5.
Hand drilling Machine
6.
Hacksaw Frame with Blade
7.
Junior Hacksaw frame
8.
Pipe/tube Cutter
9.
Water meter
10.
Cutting Plier
11.
Grip plier
12.
Slip Joint Plier
13.
Screw Driver
14.
D/E Spanner(6 to 32 mm)
set
15.
Box Spanner(6 to 32 mm)
set
16.
Jumper Bit
17.
Flat Chisel
18.
Sledge Hammer
19.
Pipe vice
20.
Pipe Die Set
21.
Pipe wrench
22.
Shifting Spanner
23.
Wire Brush
24.
Personnel
Equipments
25.
Teflon Tape/ Solution
Sufficient
quantity
26.
Emery Sheet
Sufficient
quantity
2016 - 2017
Protecting
Sufficient
quantity
21 | P a g e
27.
GI Pipes & Accessories
Sufficient
quantity
28.
PVC Pipes & Accessories
Sufficient
quantity
29.
Other Consumables
Sufficient
quantity
13.
DETAILS OF THE FINANCIAL STATUS OF THE TRUST
S.No
Amount [ Rs. ]
Description
1.
Endowment created with AICTE
2.
Current / Savings Account
Name of the Bank
Account Number with Amount
3.
Land Value
4.
Building Value
5.
Total Investment on Library Books till date
6.
Total Investment on Equipments till date
7.
Expenditure on Salary
8.
Annual Budget Recurring
9.
Annual Budget Non-recurring
Audit Report [Income / Expenditure]
10.
YES / NO
ENDOWMENT FUND CREATED BY THE TRUST WITH AICTE
Name and
Place of Bank
Amount
(Rs. in Lakhs)
Deposited in the bank
(name)
Date of
Maturity
Instrument No. and date
DETAILS OF BANK BALANCE AMOUNT
Type of
Account
Whether Account in the
name of Trust / College
Name and
Place of
Bank
Account
Number
Balance as
On date
Amount
( ` in Lakhs)
Extent (sq.m)
Built-up
area (sq.m)
Guideline
Market Value (`)
Current
Savings
VALUE OF LAND AND BUILDING
Survey
Number
2016 - 2017
Location
Value (`)
22 | P a g e
14.
Sl.
No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
DOCUMENTS, REGISTERS AND RECORDS
The following Documents, Registers and Records should be maintained / available in the Institution and
it should be produced for verification at the time of inspection to the inspection committee members.
Name of Register / Record
Maintained / Available
(YES / NO)
AICTE Web-portal Copy granting approval for Institution / Programmes(s)
AICTE Letter of Approval Copy for Institution / Programmes(s)
Department wise faculty profile
Department wise Non-Teaching Staff Profile
Attendance for teaching and non-teaching staff
Advertisement for recruitment of faculty members
Minutes of the meeting of Staff Selection Committee
Appointment / offer letters issued to faculty members
Joining report of staff members
Copy of Regulations, curriculum and syllabi (programme wise)
Master time table for all courses and all sections with classroom arrangements
Academic calendar
Accession register for library
Stock register for equipment and machinery
Stock register for consumable
Stock register for furniture
Stock register for tools
Minutes of the meetings of the Governing council of the college
Minutes of the meetings of the Regd. Society / Trust / Company of the college
Audited statement of accounts of the college
Cash book of the college
Acquittance register
Fee receipt books (including counterfoils)
Funds position / bank certificates / FDR copies to indicate financial stability
Composition of the Governing council
Composition of the Anti-Ragging Committee
Trust Deed
Registered Land Documents and Sale Deed
Land Use Certificate
Land Conversion Certificate
Land Classification certificate
Village Map
Combined field map of lands
Encumbrance Certificate for land
Patta, Chitta and Adangal for land
Field Measurement Book for land
Documentary proof for ownership of lands exclusively earmarked for the College
Approved Existing Building Plan
Building Sketch [Complete details of Rooms, Labs, W/S, Stores, Library etc.]
Legal Opinion
Copy of Certificate obtained under sec. 37B of TNLRA 1961
Certificates for fire/boiler/electrical safety from competent authorities.
Certificate from Health Inspector
Certificate from PWD Supt. Engineer / Panel Engineer approved by respective
District Collector, for the structural stability of all buildings
Building and equipment insurance certificate.
2016 - 2017
23 | P a g e
LIST OF ENCLOSURES TO BE ENCLOSED ALONG WITH THE APPLICATION FORM
1.
2.
3.
4.
5
6
7
8
9
10
11
12
Registration Fee [ Rs. 5,000]
AICTE Web-portal Copy granting approval for Institution / Programmes(s)
AICTE Letter of Approval Copy for Institution / Programmes(s)
Notarized Undertaking in Rs. 100 stamp paper
Trust Deed
Registered Land Documents and Sale Deed
Land Use Certificate issued by Revenue Divisional Officer
Land Conversion Certificate issued by Revenue Divisional Officer for Wet Land
Land Classification certificate issued by Revenue Divisional Officer
If Wet Land, Certificate under Section 47 (A) of Tamil Nadu Town and Country
Planning Act, 1971
Certificate under Section 37-B on Tamil Nadu Land Reforms (Fixation of Ceiling
on land) Act 1961 (Tamil Nadu Act 58 of 1961).
Copy of the Form No.38, viz. the application form for permission by Public Trust
under subsection (1) of Section 37-B of the Tamil Nadu Land Reforms (Fixation
of Ceiling on Land) Act 1961 along with the covering letter addressed to
(1) Principal Secretary to Government, Revenue Department, Chennai 9;
(2) Commissioner of Land Reforms, Chepauk, Chennai 5 and
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
(3) Assistant Commissioner (Land Reforms) or equivalent cadre under the
jurisdiction where the Institution is located.
Village Map
Combined field map of lands
Encumbrance Certificate for land
Patta, Chitta and Adangal for land
Field Measurement Book for land
Documentary proof for ownership of lands exclusively earmarked for the College
Approved Building Plan
Copy of the proceedings issued by DTCP for approval of building plan
Copy of the Challan towards payment of infrastructure and basic amenities
charges to DTCP for approval of building plan
Building Sketch [Complete details of Rooms, Labs, W/S, Stores, Library etc.]
Legal Opinion
Certificates for fire/boiler/electrical safety from competent authorities.
Certificate from Health Inspector
Certificate from PWD Supt. Engineer/ Panel Engineer approved by respective
District Collector for the structural stability of all the building
Building and equipment insurance certificate.
All the New AICTE approved Diploma level Institutions for the year 2016-2017 are requested to submit
the application in the above prescribed format along with the enclosures for affiliation for the year 20162017.
2 Hard Copies of the application with Hard / Soft bound
1 Soft copy of Application in word format with Filename as <Institution_name.doc>
1 soft copy of Application duly signed in pdf format as Filename <Institution_name.pdf>
The above soft copies should be submitted in a CD
The above soft copies should also be sent by email to
[email protected] with Filename as
<College name> . doc.
2016 - 2017
24 | P a g e
UNDERTAKING
That I have read and understood the contents of the application and the same are true and correct on
the basis of my personal knowledge and on the basis of the records of the institution.
In connection with my / our application for the grant of affiliation of _____________________________
________________________________________________ (Name of the Institution) to conduct ___________
courses with _________ sanctioned intake, and hereby undertake to comply with the following:i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
xii.
xiii.
xiv.
That infrastructural, instructional and other facilities are being provided as per the AICTE norms,
standards and guidelines prescribed from time to time.
That the admission to the course will be made only after recognition is granted by the AICTE and
affiliation is granted by the State Board of Technical Education and Training, Tamil Nadu.
That the admission of students, satisfying the eligibility conditions will be made on the basis of marks
obtained in the qualifying examinations or as per the State Government policy in force.
That there shall be reservation of seats for SC/ST/BC/MBC/other categories as per the policy of the State
Government.
That the tuition and other fees will be charged at rates prescribed by the Competent authority.
That there shall be teaching and non teaching staff appointed as per the guideline of the AICTE / State
Government. The staff will be paid salary as may be prescribed by the AICTE / State Government from
time to time.
That the management shall discharge the statutory obligations relating to provident fund, pension,
gratuity, etc., in respect of all its employees.
That the management will make adequate funds available for providing satisfactory facilities and for
proper programme implementation announced from time to time.
That the accounts of the institution will be properly maintained and audited annually by the audit
authorities or chartered accountant and will be open for inspection.
That the institution will involve all the eligible staff members in the invigilation work, evaluation work and
any other academic assignments prescribed by the Directorate of Technical Education, Chennai from
time to time
In the event of non-compliance by the ___________________________ (Name of the Trust / Society /
Company / College / Institution, etc.,) with regard to the norms and standards of any other conditions laid
down / prescribed by the State Government / State Board of Technical Education and Training, Tamil
Nadu / Directorate of Technical Education, Chennai from time to time, the concerned authorized authority
will be free to take all necessary measures for effecting withdrawal of its affiliation, without consideration
of any other issue and that all liabilities arising out of such a withdrawal would solely be that of the
institution / management.
That the institution shall take all our efforts to eradicate ragging and AICTE / State Government / UGC
rules and regulation on ragging will be strictly enforced.
That the existing AICTE / State Government / Directorate of Technical Education, Chennai regulations
and the new regulations announced from time to time will be strictly enforced and intimated to the
authorities.
That we are aware of the fact that monitoring and enforcement of academic discipline in our campus shall
be as required by regulations of State Government / State Board of Technical Education and Training,
Tamil Nadu / Directorate of Technical Education, Chennai.
Principal
Name:
Chairman / Managing Trustee / Secretary / any other
authorized signatory
Name:
Note : A notarized undertaking in Rs.100 stamp paper duly signed by the Principal and the authorized
signatory of the trust is to be enclosed
2016 - 2017
25 | P a g e
Endorsement of the Principal
I,
Thiru.
Thiru.
Tmt.
___________________________
_____________________
on
behalf
of
son
daughter
the
(college
of
name)
___________________________ hereby declare that the particulars furnished in the
application are correct to the best of my knowledge.
Principal
(Name in Capital Letters)
Seal
Place:
Date:
Declaration by the Management
I,
Thiru.
Tmt.
___________________________
son
daughter
of
Thiru. _______________ on behalf of the trust, viz., ___________________________
hereby declare that the particulars furnished in the application are correct to the best of my
knowledge. No programme(s) will be started without the prior approval of the AICTE and the
grant of affiliation by the State Board of Technical Education and Training, Tamil Nadu for the
academic year concerned and all the original documents related to the particulars given in
the application will be produced at the time of inspection and whenever called for.
Chairman / Secretary
(Name in Capital Letters)
Seal
Place:
Date:
2016 - 2017
26 | P a g e