GUJARATUNIVERSITY

AffiliationformforNew/Renewal,Adhoc/PermanentAffiliation
programmecoveredunderArts,Commerce&ScienceFaculties

To,

The Registrar,
Gujarat University,
Navrangpura, Ahmadabad-380009

Sub: Application of Affiliation for: New Institute / Extension of Affiliation & / Additional course in
existinginstitutewithGujaratUniversityfortheAcademicsession20152016.

1. NameandAddressoftheSociety/Trust:

RegistrationNumberofthe

Trust/Society:

Name

Address
Taluka
District
PinCode
PhoneNo.withSTDCode
FaxNo.withSTDCode
EmailID
Website

2. NameandAddressoftheCollege/Institute(Existing/Proposed)

Name

Address

Taluka
District
PinCode
PhoneNo.withSTDCode
FaxNo.withSTDCode
 EmailID
Website
HasGujaratGovernment
Yes/No/NotRequired
issuedNOC?
Has
NCTE/AICTE/MCI/DCI/BCI/ Yes/No/NotRequired.
CCHrecognized?
Ifappliedin
NCTE/AICTE/MCI/DCI/BCI/
..//
CCH,indicatedateof
application.
IDIssuedGujaratUniversity
IDIssuedby
NCTE/AICTE/MCI/DCI/BCI/
CCH/

3. DetailedofAcademicProgrammesforwhichAffiliationisProposed:

NameofFaculty

NameofProgramme

UnderGraduate/Post

Graduate

MainSubject


SubsidiarySubject
AcademicYear
No.ofDivision
Time
Whichtypeofeducation

4. DetailedisrequiredasperSection33GujaratUniversity:

Sr.
Particulars Details
No.
1 PopulationofVillage/City
2 DetailsofCollegesprovidedsame

educationnearby
3 TypeofEducation

(OnlyWomen/Coeducation)
4 ExpatiationofIntakeofStudents
5 ReasonforOpeningnewCollege
6 DefineAreaofCollege
7 MediumofStream/Instruction

5. WhetherCollege/InstituteisGovernment/Aided/UnAided:Govt./Aided/UnAided
6. WhetherCollege/InstituteisregisteredasaMinorityColleges?:Yes/No
7. IfYes,typeofMinorityLinguistic/Religionetc.::Linguistic/Religion
8. NameandAddressoftheExistingCollege/InstituterunbytheSociety/Trust

No. College/InstituteName Programme NameofUniversitywithaffiliation

9.
LandAvailability(Attachalltherecords)

Sr Parameter Details
1 LandCategory MetropolitanCity/OtherArea
AreaRequiredasperLandCategory
2 1.5Acres/2.0Acres/5.0Acres
(Acres)
3 TotalAreaAvailable(Acres)
PlotNo.:
4 LandDetails SurveyNo.:
BlockNo.:

5 LandAddress

WhetherLandisownedbyTrust?
6 (Attach7/12,8A,6Certificates) Yes/No

WhetherLandisundisputed?If
7 disputed,specifydetailsofdispute Yes/No
withdocuments
WhetherLandisNA?IfYes,mention
8
NAOrderandDate.(AttachNAOrder)
WhetherLandisfreeofanydebt?
9
(Attachcertificate)
Whetherthesaidlandisdemarcated
10 byFencing/boundarywallforthe Yes/No
College/Institution?
11 Whetherthesaidlandiscontiguous? Yes/No

10.
BuildingAvailability(Attachalltherecords)

Area(LengthXBreadth)(inSquare
Sr ParticularsforEachUnit
Meters)
1 Length:Meter
TotalClass Breadth:Meter
Room Area:.Meter
2 Length:Meter
Tutorial Breadth:Meter
Room. Area:.Meter
3 Laboratory Length:Meter
Breadth:Meter
Area:.Meter


4 DrawingHall Length:Meter
Breadth:Meter
Area:.Meter
5 Workshop Length:Meter
Breadth:Meter
Area:.Meter
6 SeminarHall Length:Meter
Breadth:Meter
Area:.Meter
7 ComputerCenter/ Length:Meter
Breadth:Meter
Area:.Meter
8 Library/Reading Length:Meter
Breadth:Meter
Area:.Meter
9 Reading Length:Meter
Breadth:Meter
Area:.Meter

11. TotalInstructionalArea(CarpetArea)inSquareMeter

ForExistingIntake
For Numbers Area
Particulars
UG/PG
Required Available Required Available
ClassRooms

TutorialRooms

Laboratories

DrawingHall

Workshop

SeminarHall

ComputerCenter
LibraryandReading

Room

Total


12. Administrative/AmenitiesArea(CarpetArea)inSquareMeter

ForExistingIntake
Particulars Numbers Area
Required Available Required Available
Principal/DirectorOffice

BoardRoom

OfficeallInclusive

DepartmentOffices
CabinsforHeadofthe
Departments
FacultyRoom

ExaminationsControlOffice

PlacementOffice

CentralStores

Maintenance

Security

HouseKeeping

PantryforStaff

Toilet(StaffMale)

Toilet(StaffFemale)

Toilet(Boys)

Toilet(Girls)

BoysCommonRoom

GirlsCommonRoom

Cafeteria

StationeryStoresandReprography

FirstAidcumSickRoom

Parking

PlayGround

13.
WhetherhasGoverningBodybeenconstituted?Yes/No

14. IfYes,mentionlastdateofmeeting:.............................................................................................................
14.IfYes,mentionConstitutionandCompositionoftheGoverningBody

Sr NameandAddress Designation
PhoneNo.withSTDCode.:
1 MobileNo.: Chairman/President
Email:
PhoneNo.withSTDCode.:
2 MobileNo.: ManagingTrustee/Secretary
Email:
PhoneNo.withSTDCode.:
3 MobileNo.:
Email:
PhoneNo.withSTDCode.:
4 MobileNo.:
Email:
PhoneNo.withSTDCode.:
5 MobileNo.:
Email:
PhoneNo.withSTDCode.:
6 MobileNo.:
Email:
PhoneNo.withSTDCode.:
7 MobileNo.:
Email:
PhoneNo.withSTDCode.:
8 MobileNo.:
Email:
PhoneNo.withSTDCode.:
9 MobileNo.:
Email:
10 PhoneNo.withSTDCode.:
 MobileNo.:
Email:

 15. NameandDesignationofHeadoftheCollege/Institute(Principal/Director)

Name
Designation
Qualification

Experience

HighestDegree
Specialization
TotalExperience
DateofBirth
(O):
PhoneNo.withSTDCode (R):
(M):
FaxNo.withSTDCode
EmailID
WhetherApprovedbyGujaratUniversity?
IfYes,pleasementiontheApprovalLetterNumberand

Date

16. TeachingStafffortheexistingprogramme(s)

Designation&
Type
(Prof/Asso
Category PayBand, University
Prof/AsstProf
S (SC/ST/ Qualific Dateof GradePay Recognition
Name &Permanent/
r SEBC/ ation Joining &Total LetterNo.&
Probation/
OTH/PH) Salary Date
Adhoc/Part
Time/
Visiting)
UG:
PG:
1
MPhil:
Total: PhD:
 UG:
PG:
2
MPhil:
Total: PhD:
UG:
PG:
3
MPhil:
Total: PhD:
UG:
PG:
4
MPhil:
Total: PhD:
UG:
PG:
5
MPhil:
Total: PhD:
UG:
PG:
6
MPhil:
Total: PhD:
UG:
PG:
7
MPhil:
Total: PhD:
UG:
PG:
8
MPhil:
Total: PhD:
UG:
PG:
9
MPhil:
Total: PhD:
UG:
1 PG:

0 MPhil:
PhD:

17. Registrar/OfficeSuperintendent

NameoftheRegistrar/OfficeSuperintendent
Qualification
DateofAppointment
DateofJoining
DateofBirth
PhoneNo.withSTDCode (O):(R):(M):
Email

18. NonTeachingStaffDetails

Category Designation PayBand,

(SC/ST/ (Permanent Dateof GradePay
Sr Name Qualification
SEBC/ /Probation/ Joining &Total
OTH/PH) Adhoc) Salary


1

Total:


2

Total:


3

Total:


4

Total:


5

Total:


6

Total:


7

Total:


8

Total:


9

Total:

10
Total:

19. SupportingStaffDetails(AsperListAttached)

Category Designation
PayBand,
(SC/ST/ (Permanent Dateof
Sr Name Qualification GradePay&
SEBC/ /Probation Joining
TotalSalary
OTH/PH) /Adhoc)


1

Total:


2

Total:


3

Total:


4

Total:


5

Total:


6

Total:


7

Total:


8

Total:


9

Total:

10
Total:

20. Librarian

Name
Qualification

Experience

TotalExperience
DateofAppointment
DateofJoining
DateofBirth
(O):
PhoneNo.withSTDCode (R):
(M):
FaxNo.withSTDCode
EmailID
WhetherApprovedbyGujaratUniversity?
IfYes,pleasementiontheApprovalLetterNumberand

Date

20(a).LibraryStaffDetails
Category Designation
PayBand,
(SC/ST/ (Permanent Dateof
Sr Name Qualification GradePay&
SEBC/ /Probation Joining
TotalSalary
OTH/PH) /Adhoc)


1

Total:


2

Total:


3

Total:


4

Total:


5

Total:


6

Total:


7

Total:


8

Total:


9

Total:

10
Total:

20(b).LibraryFacilities

Sr Particulars Availibility
1 TotalAreaoftheLibrary
2 SeatingCapacityoftheLibrary
3 ReprographicFacility Yes/No
4 WorkingHoursoftheLibrary ..am/pmto.am/pm
5 LibraryNetworkingFacility Yes/No
UsageDataoftheLibrary(intermsofbooks
6
issuedtothefacultyandstaffetc)
AnnualLibraryBudget(percentageofannual
7
studentfeecollected)
8 NumberofComputersinLibrary


LocalAreaNetwork
IfYes,mentionServerHardware Yes/No
Configuration HardwareConfiguration:


9 IfYes,mentionServerSoftware
Configuration SoftwareConfiguration:




10 InternetFacilityinLibrary Yes/No
11 ReadingRoom Yes/No
12
13
14
15

20(c).DetailsoftheLibraryBooks

TotalNumberof NumberofJournals
Sr TotalNumberofTitles
Volumes National International
1
2
3
4
5

21. ComputerFacility

PeripheralswithConfiguration
No.of
Sr Program Course Configuration (Printers,Scanners,LCD
Computers
Projector,

22. LocalAreaNetworkDetails:

22(a).InternetFacilityDetails:(PleaseattachPhotostatcopyoftheBill)

InternetService

Provider
Leased
TypeofConnectivity
Line/Broadband/Dongle/.
ConnectionType Dedicated/Shared

Speed
.MBPS
WiFi Yes/No




23.AuditedBalanceSheetAttached?Yes/No

24.FinanacialDetailed:Deposits/Bonds/Cashandanyother(Copyattached)

Sr. Particular Amount NameofBank Deposits

No. ReceiptNo.&
Date
1.
2.
3.
4.
5.
6.

25.OtherFacilities

Sr Parameter Availability
1 LanguageLaboratory
2 AllWeatherApproachRoad
3 PotableWaterSupply
4 ElectricalGenerator
5 DigitalLibrary
6 ParkingFacilities
7 MedicalFacilities
8 InsuranceFacilities
ReprographicFacilitiesinthe
9
College/Institute
10 SewageDisposal
11 TelephoneandFax
GeneralNoticeBoardandDepartmental
12
NoticeBoards
13 MedicalandCounselingFacilities
14 College/InstituteWebsite
15 FirstAidFacility
 16
17
18
19
20

21

22
23
24
25

Iherebyundertakethat

1. The College/Institute has constituted a Governing Body and meetings of the

GoverningBodywereheldduringtheyear..........................................,aswellasWomans
DevelopmentCell/InternalComplaintCommittee,SCSTCelletc.
2. The emoluments including allowances that are required to pay to the teachers and
other employees of the College/Institution are and shall be in accordance with the
grades allowances as per the rules. All the appointments of the teachers and other
employeesarestrictlymadeinaccordancewithrulesandregulations.
3. Allthenecessaryfacilitiesareprovidedtothestudents.
4. AllthenecessaryfundssuchasBuildingFund,SecurityFundetc.aredepositedinthe
Scheduled Bank ...................................................................................., .................................................
BranchasdirectedbytheUniversity.
5. TheCollege/InstitutehascompliedwithalltheprovisionsofTheGujaratUniversity
Act,1949andtheprovisionsofStatutes,Ordinances,RegulationsandRulesmadein
thisbehalfbytheUniversityfromtimetotime.
6. The College/Institute has complied with all the provisions of University Grants
Commission [Affiliation of Colleges by Universities] Regulations, 2009 published in
the Gazette of India, 20th February, 2010 and UGC, New Delhi letter No.F.17/2007
(CPPI)dated29thApril2010.
7. The College/Institute has complied with all the provisions of University Grants
Commission [Affiliation of Colleges by Universities] (1st Amendments) Regulations,
2012 published in the Gazette of India, 26th March, 2012 and UGC, New Delhi letter
No.F.17/2007(CPPI/C)dated20thApril2012.

(NameofthePresident/SecretaryofTrust/Society)