final saf 26-9-09-col-13paramedical veterinary science ayurveda & yoga enclosed (e) / not...

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)

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)


Enclosed (E) /

Not Enclosed (NE)Sign.Enclosed (E) /

Not Enclosed (NE)

Signature with Seal of President of Society / Trust(In original with date)


of 28

S. No. MAIN DETAILS


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)


Enclosed (E) /


Enclosed (E) /

Not Enclosed (NE)



of 28

S. No. MAIN DETAILS


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



Mobile No.

G-7


Residence Phone No. (with STD Code)

Mobile No.


Enclosed (E) /


Not Enclosed (NE)



of 28

S. No. MAIN DETAILS


Applicant)CHECK

LISTREMARKS

Authorization is sought for New Centrewith Stream / Additional

G-8 Name of signing authority

Personal Address

Designation



G-9

His/Her Specimen signature

Approval letter by the Director of being an

authorised signatory

Mobile No.

New / Additional

a)

b)

c)

d)


Enclosed (E) /


Minimum commitment of intake for every Sem / yr.

Enclosed (E) /

Not Enclosed (NE)



of 28

S. No. MAIN DETAILS


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


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





S. No. MAIN DETAILS


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


Enclosed (E) /


To be indicated in Blueprint

To be indicated in Blueprint

# 1 #2 #3

# 1 #2 #3

Enclosed (E) /

Not Enclosed (NE)

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


Applicant)


Enclosed (E) /


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









Reception Area Indicated a) Yes b) No

I-9 Class Room Furniture (Total no. of sets)

Benches

Enclosed (E) /

Not Enclosed (NE)

Indicated



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


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)


Enclosed (E) /


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)



of 28

S. No. MAIN DETAILS


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.


Enclosed (E) /


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)





S. No. MAIN DETAILS


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


Enclosed (E) /


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

of 28

S. No. MAIN DETAILS


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


Enclosed (E) /


d) Authorised Schedule of the students sent by

the Study Centre (for marking attendance)

Enclosed (E) /

Not Enclosed (NE)



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




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) /


Attendance Register for Faculty & Counsellors

Enclosed (E) /

Not Enclosed (NE)



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


(attach List)

F-4 No. of External Practical Classes (Contact Hours) conducted at the Study centre / per program

(attach List)


(attach List)

Enclosed (E) /


Not Enclosed (NE)



of 28


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)


Enclosed (E) /


Not Enclosed (NE)



of 28


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




Enclosed (E) /


Not Enclosed (NE)



of 28


Applicant)

3rd Inspection Conducted

CHECK LIST

REMARKS



Inspection Report Copy attached

Inspection Report signed by (Auth Signatory

of Study centre)

Reported Discrepamcies removed



of Study centre)

Reported Discrepamcies removed

4th Inspection Conducted





of Study centre)

Reported Discrepancies removed


Enclosed (E) /


Not Enclosed (NE)



of 28


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)


Enclosed (E) /


Not Enclosed (NE)



of 28


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


Enclosed (E) /


Not Enclosed (NE)



of 28


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


Enclosed (E) /


Not Enclosed (NE)



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)


Enclosed (E) /


S. No.

Note :

Declaration :

Enclosed (E) /

Not Enclosed (NE)



DETAILS CHECK LIST


VERIFIED byIASE


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


Details of the Member No. 2. of the Inspecting Team

Name

Contact Nos.


Address



DETAILS CHECK LIST


VERIFIED byIASE


CHECK LIST

REMARKS

Qualification


Details of Verifier

Name

Contact Nos.


Address



of 28


Applicant)

VERIFIED byIASE


CHECK LIST

REMARKS

Enclosed (E) /


Not Enclosed (NE)






Applicant)

VERIFIED byIASE


CHECK LIST

REMARKS

Enclosed (E) /

Not Enclosed (NE)

Sign.Enclosed (E) /

Not Enclosed (NE)

NOTES

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final saf 26-9-09-col-13paramedical veterinary science ayurveda & yoga enclosed (e) / not...

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