Date of issue of Application Form : 21 st April 2014 Last date of submission of completed Form : 27 th May 2014

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Entrance Examination Form for Admission To (A) Course ( 4 years) Session 2014 (B) Post Basic Course (2 years) Session 2014 in the Affiliated Colleges of K. G.

Post/Speed Post or by Hand) Admit card to be collected personally on : 7 th June 2014 Entrance Exam : 8 th June 2014 Place of Examination : Lucknow Declaration of

1 Entrance Examination Form for Admission To (A) Course ( 4 years) Session 2014 (B) Post Basic Course (2 years) Session 2014 in the Affiliated Colleges of K. G. Medical University, U.P., Lucknow. Date of issue of Application Form : 21 st April 2014 Last date of submission of completed Form : 27 th May 2014 (by Rgd. Post/Speed Post or by Hand) Admit card to be collected personally on : 7 th June 2014 Entrance Exam : 8 th June 2014 Place of Examination : Lucknow Declaration of result by : 17 th June 2014 Counseling I : 12 th July 2014 Counseling II : 26 th July 2014 Website: , KGMU Entrance Page 1 of 11

2 INSTRUCTIONS FOR CANDIDATES 1. Candidates will be allowed to enter the examination hall only on production of Admit Card. 2. Examination will be of 120 minutes duration and will start at 11:00 am sharp. 3. Candidates are required to be present at the examination center 60 minutes before the commencement of the examination and to be seated 30 minutes before the time of examination. 4. No candidate will be allowed to enter the examination center 15 minutes after the seating time. Candidate will be allowed to leave the examination hall only after completion of examination. 5. Candidates shall sign the attendance sheet when directed to do so by the invigilators. 6. Candidates shall not be allowed to carry and textual material, printed or written matter or bits of paper or any other material except the admit card inside the examination hall. Pagers, cellular phones and electronic gadgets of any kind are strictly prohibited in the examination hall and shall be treated as use of unfair means. Candidates are advised not to bring these to the Examination Hall as there is no provision for safe keeping. 7. Candidates shall observe strict silence and attend to their paper. Any disturbance in the examination shall be deemed as misbehavior and the defaulting candidate shall forfeit the right to continue in the examination hall. The decision of the Center Superintendent shall be final. 8. Candidates shall enter the roll number on the top of the question booklet and nowhere else. Rough work, if any, may be done on the question booklet and not on the response sheet. 9. The question booklet along with the response sheet will have to be deposited with the Invigilator of the examination hall after the completion of examination. 10. No candidate should leave his/her seat in the examination hall without the permission of the Invigilator until he/she finally submits the question booklet and response sheet to the invigilator. 11. No candidate shall copy from the paper of any other candidate or permit his/her own papers to be copied or attempt to give or attempt to obtain irregular assistance of any description. 12. The question booklet and response sheet are not to be taken out of the examination hall under any condition. 13. USE BALL PEN ONLY (BLUE OR BLACK) 14. Candidate should be careful while filling the circle provided in the Answer sheet. The answer sheet shall be read by OMR Technology and marks awarded shall be final and no representation shall be entertained. 15. Candidate should ensure that the question booklet provided to him contains all the pages intact within 10 minutes of commencement of examination. Failure to maintain the discipline and to observe these instructions at the time of examination/admission shall disqualify the candidate from taking the present examination/admission and also from subsequent examination. KGMU Entrance Page 2 of 11

3 APPLICATION FORM For Session Starting- August, 2014 (Incomplete application will not be entertained) Sl. No.. Roll No. (To be filled by the Office) King George Medical University, U.P., Lucknow Application for Entrance Examination [A]- Course (4 years) (Tick the Course applying for) [B]- Post Basic Course (2 years) Colleges:- (i) Apex college of, Varanasi. (ii) Sahara College of, Lucknow. (iii) Vivekanand College of, Lucknow. (iv) Samarpan College of,chinhat, (v) G.S.R.M. College of, Sarojini Nagar. Dewa Road, Lucknow. Lucknow. Post Basic College:- B.C.M. College of, Khairabad, Sitapur. Particulars of enclosed Bank Draft: Amount: No.: Date: Clear Passport Size Photograph (Full front face, no, cap, hat or dark glasses) Name of Bank: 1. Name of Candidate: 2. Father s Name: 3. Mother s Name: Sex Male/Female: 5. Category: General/OBC/SC/ST/Others:.. 6. Date of Birth: Date Month Year.. (as mentioned in High School Certificate) Thumb impression of left hand 7. Age (on 31 st December, 2014): 8. Place of Birth:.. KGMU Entrance Page 3 of 11

4 9. Mailing Address:... City:. Pin Code:. 10. Permanent Address: 11. Phone no. Land Line: Mobile no. address: 11. Educational Qualification: Examination Year University Institution Subject % of Marks High School Intermediate GNM. Any other 12. Name of the College where admission is being sought (in order of preference) A. B. C. D. E. F. G. Attested Copies of High School, Intermediate and GNM Certificates and Caste Certificate (if applicable) of having passed/appeared in the examination to be enclosed. DECLARATION I hereby declare that the particulars given in this application form are correct. If any relevant information is found to be concealed or incorrect my candidature/admission may be cancelled. Date and Place:. Signature of the Candidate KGMU Entrance Page 4 of 11

5 ADMIT CARD Post Basic / Course Entrance Examination Sl.No... Roll No. (To be filled by the Office) King George Medical University, U.P., Lucknow (To be filled in by the candidate) 1. Name:. 2. Father s Name: 3. Mother s Name:.. 4. Institution: (From which the candidate has passed Intermediate) 5. Mark of Identification:- (i). (ii). 6. Write the following sentence in the box in your own hand writing sentence case- A quick brown fox jumps over the lazy dog. Clear Passport Size Photograph (Full front face, no, cap, hat or dark glasses) (Specimen signature of the Candidate) IMPORTANT: 1. Written examination will be held on... in Examination Hall, KGMU, Lucknow. 2. Please report 60 minutes before the time of examination. 3. Please be seated 30 minutes before the time of examination. 4. Please follow instructions provided by the invigilators. 5. Use of unfair means including use of mobile phone, blue tooth devices etc. is punishable. Signature of Invigilator during the examination Controller of Examinations King George Medical University, U.P., Lucknow Date:... THIS ADMIT CARD MUST BE PRESERVED FOR COUNSELING KGMU Entrance Page 5 of 11

6 CHECK LIST 1. Application Form Yes No 2. Bank Draft 3. High school Mark sheet 4. High school Certificate 5. Intermediate Mark sheet 6. Intermediate Certificate 7. G.N.M Mark sheet for Post Basic only 8. G.N.M. Certificate for Post Basic only 9. Registration Certificates for Post Basic only (Registered Nurse & Midwifery) 10. Caste Certificate if applicable KGMU Entrance Page 6 of 11

7 Course Rules & Regulations 1. Admission to Course in the following Colleges, which are affiliated to the University, will be made on the basis of entrance examination scheduled to be held on 8 th June 2014 (Sunday). (ii) Vivekanand College of, Lucknow. (iii)sahara College of, Lucknow. (iv) Apex College of, Varanasi. (v) Samarpan College of,chinhat, Dewa Road, Lucknow. (vi) G.S.R.M. College of, Sarojini Nagar, Lucknow. The selection of the candidates will be strictly based on the merit of the entrance examination and preference of the college given by candidate. 2. Minimum age for admission is 17 years on or before 31 st December of the year Minimum qualifications for admission is a. Higher Secondary School Certificate Examination (12 years ) or b. Senior Secondary School Certificate Examination (10+2) or c. An equivalent examination with 12 years schooling from a recognised board or University with Science (Physics, Chemistry and Biology) with English with a minimum 45% aggregate marks. 4. Duration of Course is four years. 5. Both males and females are eligible. Vivekanand and Sahara have seats for females only. 6. Candidates must be medically fit additional medical check up may done before admission (the candidates who are in the merit list are required to submit certificate of physical fitness from registered medical practioner). 7. Candidates for the entrance test will have to deposit a fee of Rs. 1500/- (Rs. 1200/- for SC/ST) through Bank Draft/Banker s Cheque payable to the Controller of Examinations, K.G. Medical University, U.P., Lucknow, along with the prescribed application form duly filled in. 8. Subjects for the written test are Physics, Chemistry, Biology, English and General Knowledge of Intermediate standard. 9. No T.A./D.A. will be paid for attending the Entrance Examination/Interview/Counseling. 10. Implementation of changes in regard to admission process/selection criteria etc. will be incorporated as per INC notification issued from time to time. 11. Any dispute in regard to any matter referred to herewith shall be subject to the jurisdiction of Allahabad High Court of Judicature, Lucknow Bench only. KGMU Entrance Page 7 of 11

8 12. The decision of the Vice-Chancellor shall be final in the matter of selection of candidates for admission to the course and no appeal shall be entertained on this subject. 13. There is no provision for rechecking of answer sheets or communication of marks obtained at the entrance examination. Result of the entrance shall be available at the website of the University. 14. Distribution of the seats:- Seats in different nursing colleges are available (as per details attached). Category wise distribution of seats will be as per UP Public Service Commission Scheduled Caste, Schedule tribes and other Backward Class Reservation amendment ordinance Seats may be increased or decreased at the time of counseling on the directives of the hon ble Vice Chancellor. 16. In the event of more than one candidate securing same marks, the merit will be decided on the basis of highest marks obtained by the candidate in the examination as per the following order: i) Higher marks in Biology, ii) Chemistry, iii) Physics, iv) Intermediate examination. 17. Counseling Procedure:- i) Counseling shall be held at K.G. Medical University, U.P., Lucknow on 12 th July and 26 th July ii) A non refundable fee of Rs. 300/- will have to be submitted through Bank Draft in favour of Controller of Examinations payable at Lucknow. iii) A separate Bank Draft of Rs. 5,000/- in favour of controller of Examination, payable at Lucknow shall have to be deposited by the candidates at the time of counseling, on award of seat. iv) The Bank Draft of Rs. 5,000/- shall be returned to candidate on his/her joining of any one of Courses. However, if the candidate opts for seat and does not join then University has the right to forfeit that money. Controller of Examinations King George Medical University, U.P., Lucknow KGMU Entrance Page 8 of 11

9 Post Basic Course Rules & Regulations (iii)admission to Post Basic Course in the following Colleges, which are affiliated to the University, will be made on the basis of entrance examination scheduled to be held on 8 th June 2014 (Sunday). B.C.M. College of, Khairabad, Sitapur. (iv) The selection of the candidates will be strictly based on the merit of the entrance examination and preference of the college given by candidate. (v) Minimum qualifications for admission is candidate should have pass GNM Course. (vi) Candidates should be a Registered Nurse & Midwifery. (vii) (viii) Duration of Course is two years. Only females are eligible as submitted by the aforesaid college. (ix) Candidates must be medically fit. Additional medical check up may done before admission (the candidates who are in the merit list are required to submit certificate of physical fitness from registered medical practioner). (x) Candidates for the entrance test will have to deposit a fee of Rs. 1500/- (Rs. 1200/- for SC/ST) through Bank Draft/Banker s Cheque payable to the Controller of Examinations, K.G. Medical University, U.P., Lucknow, along with the prescribed application form duly filled in. (xi) No T.A./D.A. will be paid for attending the Entrance Examination/Interview/Counseling. (xii) Implementation of changes in regard to admission process/selection criteria etc. will be incorporated as per INC notification issued from time to time. (xiii) The decision of the Vice-Chancellor shall be final in the matter of selection of candidates for admission to the course and no appeal shall be entertained on this subject. (xiv) Any dispute in regard to any matter referred to herewith shall be subject to the jurisdiction of Allahabad High Court of Judicature, Lucknow Bench only. (xv) There is no provision for rechecking of answer sheets or communication of marks obtained at the entrance examination. Result of the entrance shall be available at the website of the University. (xvi) Distribution of the seats:- Category wise distribution of seats will be as per UP Public Service Commission Scheduled Caste, Schedule tribes and other Backward Class Reservation amendment ordinance 2002 (as per list attached). (xvii) Seats may be increased or decreased at the time of counseling on the directives of the hon ble Vice Chancellor, K.G. Medical University, U.P., Lucknow. KGMU Entrance Page 9 of 11

10 (xviii) In the event of more than one candidate securing same marks, the merit will be decided on the basis of highest marks obtained by the candidate in the examination as per the following order: i) Higher marks in GNM, ii) Higher percentage in Intermediate. (xix) Counseling Procedure:- 7. Counseling shall be held at K.G. Medical University, U.P., Lucknow on 12 th July and 26 th July A non refundable fee of Rs. 300/- will have to be submitted through Bank Draft in favour of Controller of Examinations payable at Lucknow. 9. A separate Bank Draft of Rs. 5,000/- in favour of controller of Examination, payable at Lucknow shall have to be deposited by the candidates at the time of counseling, on award of seat. 10. The Bank Draft of Rs. 5,000/- shall be returned to candidate on his/her joining of any one of Courses. However, if the candidate opts for seat and does not join then University has the right to forfeit that money. Note: Distribution of available seats and fee structure provided by the different colleges affiliated to KGMU, Lucknow is attached separately. Controller of Examinations King George Medical University, U.P., Lucknow KGMU Entrance Page 10 of 11

11 S.N o. Distribution of available seats and fee structure provided by the different colleges affiliated to King George Medical University, U.P., Lucknow Name of Name of UR OB SC ST Total Fee Structure College Course 50 C 21 2% no. of I II III IV Total % 27 % Seats 1 Vivekana nd College of, Lucknow 2 Sahara College of, Lucknow 3 G.S.R.M. College of Lucknow 4 Samarpan College of Lucknow 5 Apex College of, Varanasi 6 B.C.M. College of, Khairabad, Sitapur (4 Years) (4 Years) (4 Years) (4 Years) (4 Years) Post Basic (2 Years) % ,15000/ / / ,600/- Include Mess +Dress+ (25000 Security Refundable) 1,11,100/- Include Mess +Dress+ (25000/- Security Refundable ) 1,03,6 00/- Includ e + Mess ,000/ / / ,000/ / / ,26,250/- + 10,000/- Caution money (Refundable) 91,250/- 91,250 / /- 4,00,000/- Including +Mess & Training fees 1,03,600/ - Include + Mess Facility available Unmarried female candidate only 4,38,900/- Female Candidate Only 75000/- 3,00,000/- Both Male & Female 67000/- 2,73000/- + fee 3500/- Per Month + 50,000/- Caution Money 91,250/- 4,00,000/- Annual expenses for & Mess Cat. No. 1-Rs. 1,92,000/- p.a. (Payable in 4 instalments), Cat no. 2- Rs. 2,16,000/- p.a. (Payable in 4 installments) Both Boys 25 % & Girls 75 % Facility is available for boys & girls Both Girls & Boys ,600/ / ,68,600/- Only Girl Students KGMU Entrance Page 11 of 11

SRI RAMACHANDRA UNIVERSITY (Declared under Section 3 of the UGC Act, 1956)

SRI RAMACHANDRA UNIVERSITY (Declared under Section 3 of the UGC Act, 1956) GROUP - A Regn. No. :... (To be filled by Office) Stream in +2 Biology Stream Non-Biology Stream Put a ( ) mark SRI RAMACHANDRA UNIVERSITY Porur, Chennai - 600 116 Affix your latest passport size photograph