APPLICATION FORM with RULES & REGULATIONS B.P.T. Course NAME (Surname First) FOR OFFICE USE ONLY

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APPLICATION NO: Suresh Brahmkumar Bhatt College of Physiotherapy (Managed by AMC Medical Education Trust) Sheth Vadilal Sarabhai Hospital Campus, Ellisbridge, Ahmedabad 380006 Ph. & Fax 091-79-26583435 APPLICATION FORM with RULES & REGULATIONS 2018 19 B.P.T. Course LAST DATE FOR RECEIVING APPLICATION 26-10 - 2018 NAME (Surname First) FOR OFFICE USE ONLY REGD.NO. : CATEGORY : CATEGORY CLAIMED : OPEN/SC/ST/SEBC MERIT MARKS : REMARKS : MERIT NO. : RECEIVER'S SIGNATURE: Page 1

INFORMATION FOR AVAILABLE SEATS AND FEES Sr. Name of the college Available Seats Fee 1 SBB College of Physiotherapy, Ellisbridge, 38 Rs. 3,27,000/- per year Ahmedabad IMPORTANT INSTRUCTIONS (1) Any Change in any of the documents or in the examination marks after submission of the application should be promptly reported to the college office with attested copy of the same. The candidate will be responsible for consequences if he/she fails to do so. (2) Admission to this college will be finalized on the basis of merit lists as prescribed under the rules.(www.medadmgujarat.org) Students should carefully read the rules for admission before submitting the application form. In the event of anything stated therein being found factually or incorrect, the admission will be liable to be cancelled. (3) A candidate seeking admission to the B.P.T. Course on Management Seats must submit his/her application in writing in the prescribed form. The form may be downloaded from www.amcmet.org, and submit to Office of the principal, S.B.B. college of Physiotherapy, V.S. Hospital Campus, Ellisbridge, Ahmedabad 380006. The form, duly filled to be submitted personally so as to reach the office of the principal on or before the prescribed last date which will be notified in the local newspaper, website and/or on the college notice board. application will be accepted or considered except submitted personally. Application will not be accepted or considered received through post / courier of any other mean. Incomplete application will be rejected. (4) No application for admission will be considered unless it is accompanied by attested copies of the certificates. (5) Students Joining College will be awarded degree from Gujarat University to which the college is affiliated. The college is also registered by Gujarat State Council of Physiotherapy. (6) All further communication will be by email only. No Page 2

RULES & REGULATIONS 1. ELIGIBILITY CRITERIA : As per Govt. of Gujarat Notification (www.medadmgujarat.org) A candidate who desires admission shall - Be a citizen of India Have completed 17 years of age on the 31.12.2018 Have passed the qualifying examination from 1. The Gujarat Board or 2. Central Board of Secondary : Provided that the school in which the candidate has studied is located in the state of Gujarat or 3. The council of Indian School Certificate examination board, New Delhi provided that the School in which the candidate has studied in the state of Gujarat or 4. The International school board (International Baccalaureate & Cambridge): provided that the School in which the candidate has studied in the state of Gujarat or 5. The national institute of open schooling: provided that the School in which the candidate has studied in the state of Gujarat or 6. 12 th qualifying examination with B group or AB group shall be compulsory 7. provided that the School in which the candidate has studied in the state of Gujarat or No candidate shall be admitted to the course unless he has passed HSC or Equivalent examination with Physics, Chemistry, Biology ( Theory & Practicals) & English subjects & also fulfills eligibility criteria under this rules Those candidates who have passed English subjects separately shall also be eligible for admission 2. MERIT LIST : Admission on the seats shall be given basis of merit list of the candidates, who have applied for admission The merit order will be first decided on the basis of a total theory marks of HSC or equivalent Exam in Biology, Chemistry & Physics subject all together. (i) The criteria for deciding merit order in case of students having equal merit marks shall be in the following sequence, namely:- (a) The candidate who obtained higher marks in theory subject of Biology in qualifying examination, in case of equal marks in Biology, higher marks in theory subject of Chemistry and then Physics shall be considered. (b) Marks obtained in English subject in qualifying examination (c) Marks obtained in Secondary School Certificate Examination (Standard 10), and (d) Date of Birth (Candidate who is older in age shall be given priority). 3. DOCUMENTS: Application will be considered only if it is accompanied by copies of the following Page 3

Certificates, duly self attested. (a) School Leaving Certificate or any other authorized document clearly showing date of birth. (b) SSCE (or its equivalent examination) mark sheet, passing certificate and attempt certificate. (c) HSCE ( or its equivalent examination) mark sheet, passing certificate and attempt certificate. (d) Caste certificate 4. The applicant shall have to produce the original certificates at the time of admission. If during scrutiny or any time there after any discrepancy or incorrectness is noticed, the admission is liable to be cancelled forthwith. The candidate could be expelled and criminal action will be initiated against him. 5. An applicant who has passed the qualifying examination from other State/National boards will be admitted provided he/she produces certificates or provisional eligibility from Gujarat University / respective university. Their admission will be confirmed only after final eligibility certificate from the University is produced. 6. (i) The tuition fees payable will be as follows:- Sr. Name of the college Fee 1 SBB College of Physiotherapy, Ellisbridge, Ahmedabad Rs. 3,27,000/- per year (ii) In addition, the student will pay enrollment fees to the University at the time of admission as prescribed by the University. (iii) (iv) The Selected student will pay Institutional Tuition Fee as prescribed from time to time. The selected student will pay the total amount institutional fee (all terms) if he/she leaves course incomplete for any reason after 31-10-2016. No fees / charges will be refunded if a student leaves the course midway for any reason whatsoever or is expelled from the college for any reason whatsoever or is prohibited by the university to pursue his studies further for any reason. Fees, once paid will not be refunded except. a. Candidate who was admitted provisionally is declared not eligible for admission by the University afterwards in which case 90% of the tuition fees will be refunded or b. Student dies during the course, proportional amount of tuition fees for unutilized term will be refunded. However, no part of other charges or fees will be refunded. 7. So long as the father of the student is alive, no other person will be ordinarily accepted as his guardian. 8. SBB College of Physiotherapy reserves the right to insert any new rule or to edit / modify / delete any rule to meet the exigencies of situation at any time. Page 4

9. The college follows the curriculum and study pattern prescribed by the Gujarat University Principal, S.B.B. College of Physiotherapy may be contacted for any details or any clarification on Tele : + 91 79 26583435 E-mail Id : sbbcollege1999@gmail.com Web : www.amcmet.org 10. All communication will be through E-mail / web site only. Candidates are requested to check their mail and our web site for any updates regularly. 11. The Jurisdiction of any dispute will be at Ahmedabad. Page 5

Consortium of Physiotherapy College Communication Address SBB College of Physiotherapy, V.S. Hospital Campus, Ellisbridge, Ahmedabad.380006 Application Form B.P.T. COURSE ON Academic Year 2018-2019 Paste Self Attested Recent Passport Size Photograph IMPORTANT: (1) Students should carefully read the rules for admission before submitting the application form. (2) Every entry in the form must be completed in detail. Incomplete applications are liable to be rejected without any further communication. (3) No application for admission will be considered unless it is accompanied by self attested copies of the certificates mentioned in Rule. (4) Students should carefully read the rules for admission before submitting the application form. In the event of anything stated therein being found factually or incorrect, the admission will be liable to be cancelled. Page 6

A: APPLICANT'S DETAILS 1. Full Name: (Surname) (First Name) (Middle Name) 2. Father's /Husband/ Guardian Name : (Surname) (First Name) (Middle Name) 3. Present Address: (Applicant) 4. Permanent Address: (Applicant) 5. Telephone No & Area Code: (Mobile) : { } {Residence} : { } (Mandatory for correspondence) {Office} : { } {FAX} : { } ( Local Contact Phone No.) (Local Mobile No.) Email Address 6. Sex : Male/Female 7. (a) Date of Birth : (Date) (Month) (Year) (b) Age in completed year: ( as on 31st December of this year ) 8. Nationality : 9. Details of S.S.C. Examination (Std. X) or its equivalent passed by student: (a) Name of Examination :(a) (b) Name of Board :(b) (c) Name of School :(c) (d) Address of School :(d) Page 7

(e) Month & year of Passing :(e) (f) Examination Seat No. :(f) (g) Marks obtained :(g) 10. Details of H.S.C. Examination (Std.XII) or its equivalent passed by student: (a) Name of Examination :(a) (b) Name of Board :(b) (c) Name of School :(c) (d) Address of School :(d) (e) Month & Year of Passing :(e) (f) Examination Seat No. :(f) (g) Marks obtained :(g) (h) Number of attempts :(h) 11. Marks obtained at H.S.C.E. or Equivalent Examination: * SUBJECT 1. Chemistry 2. Physics 3. Biology 4. English OBTAINED THEORY MARKS MAXIMUM 12. CATEGORY OPEN / SC / ST / SEBC (please tick) I solemnly declare that I have personally checked and verified all the information filled in this form and that they are correct and that no relevant information of fact is suppressed or omitted. I undertake to abide by the decision / order of the Dean/principal to cancel my admission and/or to expel me from the college and/or to prosecute me in case any incorrect information or discrepancy is found in this form either at the time of admission or at any time during the course of my study. I hereby agree, if admitted, to conform to the Rules and Regulations of the Physiotherapy College in force and that may hereafter be made for the governance of the college and undertake that so long as I am a student of the college I will do nothing either inside or outside the college that will interfere with its orderly governance, discipline and good name. Date: Place: Signature of the Signature of the Father/Guardian Student Page 8

CHECK LIST Please tick ( ) appropriate box of the documents you have submitted with this application. (Attach only the attested photocopies in the sequence given below) 1. School Leaving Certificate or other document showing place of birth. ( ) 2. S.S.C.E. / Equivalent Examination Mark sheet. ( ) 3. S.S.C.E. / Equivalent Examination Attempt certificate. ( ) 4. H.S.C.E. / Equivalent Examination Mark sheet. ( ) 5. H.S.C.E. / Equivalent Examination Attempt Certificate. ( ) 6. Any other (Please specify the document): (a) ( ) (b) ( ) (c) ( ) 7. Caste certificate ( ) Date: (Signature of Candidate) Page 9