BAIET-2016 APPLICATION FORM. B.Ed. ALL INDIA ENTRANCE TEST (BAIET-2016) School of Education. Application Number

Transcription

1 BAIET-2016 APPLICATION FORM B.Ed. ALL INDIA ENTRANCE TEST (BAIET-2016) School of Education D. Y. PATIL UNIVERSITY Accredited by NAAC with CGPA of 3.40 on Four Point Scale at A Grade Important Instructions: Please read the instructions given in the Prospectus for filling the form Use blue or black ball point pen for filling the form. Tick the appropriate boxes. All entries in this form must be in CAPITAL LETTERS only..baiet 2016 will be conducted on 2nd -June Time-11.00am to noon, venue- School of Education, D.Y.Patil University, Sector-7, Nerul,. Hall tickets will be available on centre on same day Application Number Paste your recent (not more than 3 month old) here 1.Name of the candidate in full Surname First Name Father s /Husband s Name 2. Date of Birth D D M M Y Y Y Y 3. Sex 4. Category: Male a) General b) SC ST Others, Please Specify Female Reserved OBC NT DT 5. Address for Correspondence: State Pin code 6. Permanent Address:

2 State Pin code 7. Telephone No. (with STD Code) Fax Number (with STD Code) Mobile No. 8. ID 9. Optional Subjects for Practice Teaching: Choose any two out of the following: (one should preferably match a major subject offered at the graduation level.) A - English, Marathi, Hindi, Sanskrit, Science, Economics B Mathematics, History, Geography, Commerce 10. Medium: English / Marathi / Hindi 11. Name of the University of the qualifying examination State Year Medium 12. Marks obtained at the final year Graduation examination: Sr. No Subject Marks obtained Out of Minimum for passing

3 13. Percentage of marks at the final year Graduation examination. % 14. Post-Graduation Degree (only if completed) University State Year Subject Year Marks Obtained Out of 15. Details of Test Fee paid Mode of payment D.D. In case of payment by Demand Draft: Name of Bank: Issuing Branch: D.D. No: (Enclose DD do not staple) Date: Amount: 16. Signature of Candidate 17. Declaration: I hereby declare that the information given above by me is correct and true to the best of my knowledge and belief. I have not suppressed any information. I am aware that I shall be liable to civil / criminal action by the Competent Authority against me if any information given above by me is found to be incorrect or false. Place: Date: Signature of the Candidate I have noted the above declaration given by the candidate and I agree with it. Signature of Parent / Guardian

4 BAI ET D.Y.PATIL UNIVERSITY Accredited by NAAC with CGPA of 3.40 on Four Point Scale at A Grade HALL TICKET Date of Exam:. Name and address of the Entrance Test Centre allotted to the candidate. D.Y. Patil University D.Y.Patil Vidyanagar, Nerul, Hall Ticket Number Paste your recent Candidate s Signature** Invigilator s Signature** Coordinator Sign on the photograph ** To be signed in the presence of the invigilator in Examination Hall Note : The candidate should fill in his /her name and address, affix recent photograph in the space provided in the Hall Ticket and Attendance Sheet and send them along with the Application Form. BAIET-2016 D.Y.PATIL University Accredited by NAAC with CGPA of 3.40 on Four Point Scale at A Grade ATTENDANCE SHEET Date of Exam:. Name and address of the Candidate Application Number Name and address of the Entrance Test Centre allotted to the candidate. Hall Ticket Number D.Y. Patil University D.Y.Patil Vidyanagar, Nerul, Paste your recent Candidate s Signature** Invigilator s Signature** Sign on the photograph ** To be signed in the presence of the invigilator in Examination Hall Note : The candidate should fill in his /her name and address, affix recent photograph in the space provided in the Hall Ticket and Attendance Sheet and send them along with the Application Form.

5 BAIET D.Y.PATIL University Accredited by NAAC with CGPA of 3.40 on Four Point Scale at A Grade RECEIPT Note : Candidates should fill both the copies of this format. The copy marked Candidate s Copy will be sent to as receipt for payment of Entrance Test Fee. Name & address of the CandidateApplication Number Particulars of the Demand Draft: Name of the Bank Issuing Branch D.D.No Date Amount Received the Entrance Test fee as mentioned above. Date:Stamp Accounts Clerk/Cashier Note : Candidates should fill both the copies of this format. The copy marked Candidate s Copy will be sent to as receipt for payment of Entrance Test Fee. Name & address of the CandidateApplication Number Particulars of the Demand Draft: Name of the Bank Issuing Branch D.D.No Date Amount Received the Entrance Test fee as mentioned above. Date:Stamp Accounts Clerk/Cashier