Page 1 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Your Date of Dispatching SAF : .......... / ....... / ........ Date of Receipt of SAF at IASE : ....... / ...... / ......
Note: 1) This form should be filled in Capital letters; neatly by hand; No column should be left blank, Write N.A. if not applicable.
2) It is mandatory to attach all documents / evidence highlighted in CHECK LIST column
3) The SAF shall be filled in BLUE INK only and should be LEGIBLE else it will be outrightly rejected
Applied for (please tick) New Centre Additional Stream Renewal Change of Address
GENERAL DETAILS
G-1 Study Centre Code (if allotted any by IASE)
G-2 Name of the Educational Institute
G-3 Postal Address
Pin Code
Website
E-Mail ID
Contact nos (Land line) with Std code
Fax. No.
CHECKLIST FOR
INSPECTING TEAM
Date of Inspection :
(For Official use only)
Name of Inspecting Team Members :
a)
b)
SELF ASSESSMENT FORM
S. No. MAIN DETAILS
CHECK LIST
(To be filled by
Applicant)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Streams IT & Management Engineering Traditional
CHECK
LISTREMARKS
Paramedical Veterinary Science Ayurveda & Yoga
Enclosed (E) /
Not Enclosed (NE)
Page 2 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)
Other related Details for Accounts :
CHECK
LISTREMARKS
PAN NO. (Institutional / Society / Trust)
Bank A/c No.
Name of the Bank
Copy of Letter Head (Approved by the
University. Attach a cancelled original Letter Head)
G-4Name of the Registered Society / Trust
Address
Pin Code
Website
E-mail ID
Contact Nos (Land line) with STD code
Fax. No.
PAN No. (Society / Trust / Institute)
Validity of registration (upto)
(Enclose copy of registration)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 3 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
New Study Centre
Change of Director / any other Official
G-5Name of President of the Society / Trust
Educational Qualification
Office Phone No. (with STD Code)
Mobile No.
PAN No. (personal)
Bank A/c No.
Name of the Bank
(Enclose copy of appointment)
G-4a Resolution of the Society attached for
Additional Stream
Change of Address
Personal Address
Residence Phone No. (with STD code)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 4 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
Personal Address
Name of Co-ordinator / Representative
Designation
Personal Address
G-6Name of Director / Principal
(Enclose copy of appointment)
Educational Qualification
Professional experience
Approval letter by the Director of being
an authorised signatory
Office Phone No. (with STD Code)
Residence Phone No. (with STD code)
Mobile No.
G-7
Office Phone No. (with STD Code)
Residence Phone No. (with STD Code)
Mobile No.
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 5 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
Authorization is sought for New Centrewith Stream / Additional
G-8 Name of signing authority
Personal Address
Designation
Office Phone No. (with STD Code)
Residence Phone No. (with STD code)
G-9
His/Her Specimen signature
Approval letter by the Director of being an
authorised signatory
Mobile No.
New / Additional
a)
b)
c)
d)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Minimum commitment of intake for every Sem / yr.
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 6 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)
CHECK
LISTREMARKS
G-10Name of stream (s) for which already
Authorized. (for Existing Centre)
a)
INFRASTRUCTURE DETAILS
Date of Authorization and letter no.
(enclosed copy of the letter)
b)
c)
d)
(MUST ENCLOSE PHOTOGRAPHS / CD)
I-1 Rate the exterior and interior of the
centre whether it has an aesthetic
look worthy of a quality educational set up
Good
Average
Not worthy
No. of photographs / CD enclosed
I-2Whether Sign board of University has
been put outside the building (Mandatory)
I-3Whether Notice board is displayed at
reception area
(Tick your Status)
a) Yes b) No
a) Yes b) No
a) Yes b) No
Quantity
a) Yes b) No
a) Yes b) No
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
No. of Enrolled Students
New RR
( In the previous semester)
Study centre is running in ( Attach details) Existing school College Institution
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 7 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
I-4Whether all important docs mentioned below
are displayed at reception area
Important Notice
Whether reception area is properly mantained
Time table
Photographs
Publicity material of IASE
I-5
Building Details :I-6
Total Area of Institute (in Sq. Ft./size)
Total No. of Rooms in Institute :
Total Area of Rooms Covered (in. sq. ft.)
Open Space (in sq. ft.)
Parking Space (in.sq. ft.)
Dedicated Infrastructure for IASEI-7
No. of Class Rooms with size in sqft
No. of Counseling Room with size in sqft
No. of Labs with size in sqft
No. of Computers
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
# 1 #2 #3
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
To be indicated in Blueprint
To be indicated in Blueprint
# 1 #2 #3
# 1 #2 #3
Enclosed (E) /
Not Enclosed (NE)
Page 8 of 28
S. No. MAIN DETAILSCHECK
LISTREMARKS
No. of Books
I-8Original Blue print of the building /
Institute indicating the SIZE and use of
Each Room for Students
Hall
a) Yes b) No
a) Yes b) No
a) Yes b) No
Indicated
Indicated
CHECK LIST(To be filled by
Applicant)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Classroom
Benches
Library
Director's room
Labs
Staff Room
Meeting Room
Toilets
Other Facilities (Store, Pantry, Dining etc.)
Total No. of Students who can be trained
at a time in IASE study centre
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Indicated a) Yes b) No
Reception Area Indicated a) Yes b) No
I-9 Class Room Furniture (Total no. of sets)
Benches
Enclosed (E) /
Not Enclosed (NE)
Indicated
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 9 of 28
I-11Distance from nearest other Study Centre of IASE
Name of the centre
Streams authorized for
( in Kms)
I-10 Rate the Quality and finish of
Walls
Interiors
Furniture and fixtures
Good Average Poor
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
Details of Premises :(Please tick the correct information)I-12
a) The land & building are owned by the centre (relevant documents attached)
b) If the building is rented, the lease deed of the Society / Institution is enclosed
c) The Centre has its own laboratory (s)
as per norms (AICTE, UGC norms)
Power Back upI-13
Generator/s with brand & capacity (KVA)
a) Yes b) No
a) Yes b) No
a) Yes b) No
(Attach Copies of Bills / Invoice of Purchase)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Tables & Chairs
Computer Chairs
d) The Centre has tie up with an approved
College / ITI / Institution as per IASE guidelines. a) Yes b) No
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 10 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
LIBRARY DETAILS
Location of the Study CentreI-16
a) Remote/ AreaResidential/Commercial
b) Within the city
c) Outskirts of the city
d) Nearest Airport
f) Nearest Bus stop
a) Yes b) No
a) Yes b) No
a) Yes b) No
City Distance (In kms)
City Distance (In kms)
City Distance (In kms)e) Nearest Railway Station
(Attach Copies of Bills / Invoice of Purchase)
Teaching Aids (Provide details with bills / invoice)
S. No. Teaching Aid Brand Specification Qty Sufficient for.... students
a) Yes b) No
I-14
Is the institute authorized Study Centre of any other University ?I-15
If yes (attach list) S. No. University No. of existing students Course Year / Sem.
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Invertors- Mention brand & KVA (Attach Copies of Bills / Invoice of Purchase)
L-1 Description of Library (Area in sq. ft.)
Total no. of books available in Library
Total no. of books for IASE Univ’y only
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 11 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
No. of books Stream wise
b) Attach Copies of Bills/Invoice of Purchase
L-2
S. No. Name of Stream - Name of Course - Title of the book Author No. of Copies Accession No.
TIE UP FOR LABS
Copy of MOU/Agreement for External
Arrangements for Labs / Workshop &
other facilities for Practicals - (Stream wise)T-1
Paramedical
(Only if answer to Point I-12 is NO.)
a) Yes b) No
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Engineering a) Yes b) No
Enclosed (E) /
Not Enclosed (NE)
a) Enclose the entire list of books available
c) Enclose list as per format given below
The books are accessioned in the
Accession Register (enclose
photocopy of the Accession register)L-3
Names of Periodicals / Journals (attach list)
Total No. of Books Accessioned Till Date
Total No. Books Accessioned per year
Last No. of Accession Register
a) Yes b) No
a) Yes b) No
Page 12 of 28
S. No. MAIN DETAILS
CHECK LIST(To be filled by
Applicant)CHECK
LISTREMARKS
Veterinary Science Programmes
a)
b)
c)
MOU, on an affidavit, has the following:T-2
a) Name and address of the Hospital / Lab / Hotel /
ITI / Engg College / Vet Hospital (Docs & Profile enclosed)
b) Distance of the Institution from the study
centre (Should be max. 25kms)
c) No. of Practical Classes to be
conducted / semester
d) Charges / Classes / Students
e) Schedule of Classes (Course, Subject,
Timings and days, Faculty
f) Seal & Signature of both the parties
g) For Paramedical courses separate permission for conducting specific programme(s) to be mentioned in the agreement / MOU / tie up with Lab/ Hospitals
Has maintained the following records :T-3
a) Payslips / record of engaged faculty
b) Payslips / record of Students charged
c) Attendance Register of the students
attending the practical classes
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
d) Authorised Schedule of the students sent by
the Study Centre (for marking attendance)
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 13 of 28
S. No. MAIN DETAILS CHECK LIST
(to Be Filled ByApplicant)
LAB DETAILS at STUDY CENTRE
L-1 No. of Labs at the study centre :
(Attach individual list with details as
per the format given on Right Hand
Side Also attach Copies of Bills /
Invoice for Purchase
List Equipments in Lab 1
List Equipments in Lab 2
List Equipments in Lab 3
List Equipments in Lab 4
L-2Computer Labsa) List with information details
b) Attach Copies of Bills / Invoice for Purchase
Server (details mentioned)
No. of Computers (List Attached - with configuration
List of Software (list enclosed)
No. of Printers - (List attached with configuration)
Internet connection (Specify Service provider with Plan)
UPS (List with brand and VA)
Stream Subject Name of Equipts Qty. Sufficient for students
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
CHECK LIST
REMARKSSIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
Attendance Register for Faculty & Counsellors
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 14 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
VERIFIED byIASE
(To be filled by IASE)
FACULTY and CLASSES DETAILS
F-1 Course wise Faculty - Stream wise : (enclose list as per sample below)
a) Biodata with Photographs attached
b) For Nature of Employment please use the following abbreviation :
P- Permanent V-Visiting faculty G-Guest
c) Please attach different sheets for different streams and Course
CHECK LIST
REMARKS
S. No. Stream - Course - for Subjects Name of Faculty - Qualification Exp (in yrs) - Contact No - Dt of Employ’t Nature of employ’
F-2 No. of Theory Classes (Contact Hours) conducted at the Study centre / per program
Stream Program Subject No. of classes scheduled
(attach List)
F-3 No. of Internal Practical Classes (Contact Hours) conducted at the Study centre / per program
Stream Program Subject No. of classes scheduled
(attach List)
F-4 No. of External Practical Classes (Contact Hours) conducted at the Study centre / per program
(attach List)
Stream Program Subject No. of classes scheduled
(attach List)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 15 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
CHECK LIST
REMARKS
F-5No. of Internal Compulsory Assess-
ments attended by each student per
year / sem.
(Attach subject wise List)
SUPPORT CELL
Students - Support CellS-1
Constitution (Responsibility Chart)
Statistics Attached (Record / Register)
Details Attached (with formats)
Modus Operandi Attached
Placement CellS-2
Constitution (responsibility chart)
Record / register
Details attached (with formats)
Modus Operandi attached
Statistics regarding placement etc.. attached
(Record / Register)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 16 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
S-3 Courier Services availed
Branch & Address
Contact Name
Mobile No.
Land line No.
INSPECTION CONDUCTED
Conducted on date and Time
Name(s) of Inspecting Team members
Name(s) of Study Centre’s Attending Officials
Inspection Report signed by (Auth Signatory of
Study centre)
Inspection Report Copy Attached
CHECK LIST
REMARKS
Name of Courier
In-1 1st Inspection Conducted
Reported Discrepancies Removed
2nd Inspection Conducted
Conducted on date and Time
Name(s) of Inspecting Team members
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 17 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
3rd Inspection Conducted
CHECK LIST
REMARKS
Conducted on date and Time
Name(s) of Inspecting Team members
Inspection Report Copy attached
Inspection Report signed by (Auth Signatory
of Study centre)
Reported Discrepamcies removed
Inspection Report Copy attached
Inspection Report signed by (Auth Signatory
of Study centre)
Reported Discrepamcies removed
4th Inspection Conducted
Conducted on date and Time
Name(s) of Inspecting Team members
Inspection Report Copy attached
Inspection Report signed by (Auth Signatory
of Study centre)
Reported Discrepancies removed
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 18 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
CHECK LIST
REMARKS
No. Students admitted (Pl. add additional
sheets if required)
ADMISSION PERFORMANCE
AD-1Year Sem Stream Course New RR Due
DD/ Chq.No. Date Bank Amount
Authorisation fee paid
Renewal fees paid
For the Year
FINANCIAL PERFORMANCE
For the Stream
FP-1
Additional Stream Authorization fee
For the Stream
For the Year
For the Year
Pending dues on any other account
(Attach Details)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 19 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
CHECK LIST
REMARKS
AI-1GRADE your Centre (Pls add additional sheets if required)
a) Excellent
b) Good
c) Satisfactory
d) Poor
OTHER IMPORTANT INFORMATION
O-1 Affidavit submitted Dated Copy attached
a) Regarding Compliance of University Norms
b) No criminal record
c) Dispatch record : No. / Consignment
O-2 Were you ever issued a Showcause Notice?
( Attach copies of each )
If yes, when ( date / reference no. )
For the Reason
When did you reply
ADDITIONAL INPUTS
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 20 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
CHECK LIST
REMARKS
AI-4 Copies of the following documents of your Institute / College / ... attached
a) Prospectus of the Institute
d) Visiting Card
e) Letter Head
Changes carried out, if any in the above, is to be
intimated to the University with a copy of same
b) Profile of the Institute
c) Publicity Material
Reason for change
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
a) Yes b) No
AI-2 Any other Information you wish to provide to the University (Pl. add additional sheets if required)
AI-3 Vision of your Study Centre & why do you want to associate with IASE University
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 21 of 28
MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
CHECK LIST
REMARKS
a) Incomplete Forms will be outrightly rejected.
b) Forms without enclosures / documents / details asked - will be considered INCOMPLETE.
c) Do not leave any column blank.
d) If any incorrect information is provided to the University, the centre may be rejected and the fees forfeited .
e) All details should be filled and indicated in the checklist.
DETAILS of PAYMENT being Done
(All Payments to be done in favour of “Registrar, IASE University” payable at Sardarshahr / New Delhi
For Centre Authorisation / Additional Stream Authorization
DD No.
Dated
Drawn on Bank
Amount in Figure
Amount in Words
Attach Stamp Size Latest Photograph (original)
Attach Stamp Size Latest Photograph (original)
SIGNATUREOF VERIFIER(To be filled by IASE)
Enclosed (E) /
Not Enclosed (NE)Sign.
S. No.
Note :
Declaration :
Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
DETAILS CHECK LIST
(to Be Filled ByApplicant)
VERIFIED byIASE
(To be filled by IASE)
CHECK LIST
REMARKS
Qualification
Specimen Signature of the Member
Details of the Member No. 1. of the Inspecting Team
Name
Contact Nos.
Authorization vide letter no.
Address
Qualification
Specimen Signature of the Member
Details of the Member No. 2. of the Inspecting Team
Name
Contact Nos.
Authorization vide letter no.
Address
Page 22 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
DETAILS CHECK LIST
(to Be Filled ByApplicant)
VERIFIED byIASE
(To be filled by IASE)
CHECK LIST
REMARKS
Qualification
Specimen Signature of the Member
Details of Verifier
Name
Contact Nos.
Authorization vide letter no.
Address
Page 23 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 24 of 28
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
VERIFIED byIASE
(To be filled by IASE)
CHECK LIST
REMARKS
Enclosed (E) /
Not Enclosed (NE)Sign.Enclosed (E) /
Not Enclosed (NE)
Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
Page 25 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
VERIFIED byIASE
(To be filled by IASE)
CHECK LIST
REMARKS
Enclosed (E) /
Not Enclosed (NE)
Sign.Enclosed (E) /
Not Enclosed (NE)
Page 26 of 28Signature with Seal of President of Society / Trust(In original with date)
Signature with Seal of Director of Institute(In original with date)
S. No. MAIN DETAILS CHECK LIST(to Be Filled By
Applicant)
VERIFIED byIASE
(To be filled by IASE)
CHECK LIST
REMARKS
Enclosed (E) /
Not Enclosed (NE)
Sign.Enclosed (E) /
Not Enclosed (NE)
NOTES
Page 27 of 28
NOTES
Page 28 of 28