Admission Form No: (For Office use only) ACPC Reg.No: ACPC Merit Score : ACPC Merit Rank: NAVRACHANA UNIVERSITY School of Environmental Design and Architecture Vasna- Bhayli Road, Vadodara 391410 Gujarat, India Tel. 91-265-3020100, Tel/Fax. 91-265-3020110 Email:admissions@nuv.ac.in, Website: www.nuv.ac.in APPLICATION FOR ADMISSION TO FIRST SEMESTER OF FIVE YEAR BACHELOR OF ARCHITECTURE PROGRAMME 2016-17 (For MANAGEMENT / N.R.I/ N.R.I Sponsored Seats) NOTE 1. Application form to be filled by the applicant in his/her own handwriting 2. Late submission of Application form/certificate will not be accepted. Passport size 3. Applicant to produce original certificate at the time of Admission. Photograph 4. Application form fees: Rs. 350.00,Demand Draft drawn in favour of Navrachana University, Payable at Vadodara.(Only Demand draft will be accepted) 5. Applicant has to fill only one form for all categories. Applied for 1) Management Seat 2) NRI 3)NRI Sponsored seats (Please tick against appropriate category) 1. Name of the student (In Block Letters) (Surname) (Name) (Father s Name) 2. Date of birth 3. Place of birth 4. Father s Name 5.Mother s Name 6. Nationality 7.Gender 8. Permanent address Phone Mobile No Email 9. Local address Parent s Mobile : Email ID: Applicant s Mobile: : Email ID: 10. Parent s Occupation : 1
11. NATA score 12. EDUCATIONAL DETAILS: Sr. Examination Examination Board Year of Percentage Percentile Passing 1 SSC (10 th Standard) 2 HSC (12 th Standard) I hereby declare that the information given above is true. If found false, I understand that my admission will be cancelled. I have read the rules & regulations of admissions carefully and agree to abide them. Signature of Parent/ Guardian Signature of Candidate List of documents attached herewith application: a. 10 th (or its equivalent examination) Mark-sheet & Passing Certificate b. 12 th (or its equivalent examination) Mark-sheet, Passing Certificate c. School Leaving Certificate/Transfer Certificate showing date of birth d. Copy of NATA Score card. e. Copy of Acknowledgement of ACPC. f. Equivalence Certificate from Abroad Student (NRI candidate) g. Document for proof of residence (NRI / NRI sponsor) h. Notarized Undertaking/Affidavit from NRI Parent / Guardian / Sponsor, Undertaking in regards of fees from Student / Parent on separate Rs.100/-stamp paper (for NRI/ & NRI Sponsored Candidate) i. Attested Color Photocopy of Passport of NRI/ NRI Sponsor (for NRI/NRI Sponsored candidate ) ( sponsorer s signature should be clearly visible) j. Copy of passport of admitted student and copy of passport of his/her mother and/or father proving NRI status (NRI candidate) 2
Undertaking (Applicable to NRI/NRI Sponsored seats) (To be drafted on Rs.100/- Stamp Paper with Notary) KNOW ALL MEN BY THEIR PRESENCE that we ( student ) (Name of student) and ( the guardian ) (Name of father / guardian) Hereby undertake to the Dean, School of Environmental Design and Architecture that: If the student is granted admission in Academic Year 2016-17 in the first year of B.Arch. Program in the Institute on N.R.I / N.R.I sponsored seat has to pay fees as per the Notification of the University. We agree that until we pay the aforementioned fees and fee difference in full, we will not claim LC/TC, transcript, degree certificate, or any other papers from the College. Until all outstanding tuition and other fee amount are cleared by us, the college will have the right to deny the student registration, and to retain the LC/TC, transcript, degree certificate, of and other papers. I/We also agree that if I leave the college for some reason before completing my degree program, I will pay the full fees for all five year that I would have paid if had completed my degree program. I will not be able to claim Mark sheet of HSC, and other relevant papers from the college. Once the admission is confirmed under the N.R.I/ N.R.I sponsored seats, student will not be permitted to change the category and will have to continue in the said category throughout the course of the study. Signature of Parent/ Guardian Signature of Candidate 3
UNDERTAKING (Applicable to NRI/NRI Sponsored category Seats only) (To be drafted on Rs.100/- Stamp Paper with Notary) I had applied for admission in (College) in first year of Bachelor of Architecture in Academic Year 2016-17. The college having accepted my request has granted me the admission as per the due procedure. I hereby state an oath that whatever information I have given in my application is correct and if at any stage it is found to be false my admission can be cancelled and I can be expelled from the college. Further I understand that all the fees paid by me to the college will be forfeited and the college may take further appropriate legal action. I also understand that once I accept the admission to the first year of the college I will be required to complete my entire degree program in the college. I will not be permitted to seek transfer to any other college or leave the course midway. In all the circumstances I will be required to pay the fee for the entire duration of the degree program irrespective of my continuing as a student or otherwise. The tuition fees at present are fixed at USD 5000/- per year or equivalent in Indian rupees. I have clearly understood the rule that, once the applicant is admitted in the N.R.I /N.R.I sponsored seats he / she will not be permitted to change the category and will have to continue in the said category throughout the course of the study. Signature of the student Place: I have read the above undertaking given by my son/daughter/ward and I undertake to make payments as stated above on his / her behalf. Signature of parent / guardian Name: Place: 4
AFFIDAVIT (Applicable to NRI Sponsored Seats) (To be notarized in India / Abroad) I, Son / Daughter of aged adult, occupation:, do hereby state and declare on solemn affirmation as under. 1. I am a citizen of, since 2. is related to me on account of he/she being my 3. is eligible for admission to NRI category for the academic year 2016-17 as a student of First year Bachelor in Architecture at School of Environmental Design and Architecture. Navrachana University, Vasna- Bhayli Road, Vadodara. 4. In view of the above, being a citizen of and hence a non resident of Indian. I am ready, willing and prepared to undertake all the responsibilities of the admission and education of under NRI category in the aforesaid college including the fees to be paid for the same. 5. The above name student seeking admission to NRI category is eligible for the said admission, in as much as, a part from the fact that the said student fulfils the requirement for the purpose of admission of NRI category, the said student also possesses the requisite eligibility qualification as laid down by the Council of Architecture / All India Council for Technical Education, New (Deponent) Delhi and the concern University to which the aforesaid college is affiliated. An authenticated true copy of mark of the said student at the concerned qualifying examination is annexed to the present affidavit for the purpose of establishing his / his (deleted which is not applicable) claim for the purpose of the aforesaid admission. Solemnly affirmed at on this day of month of 2016. (Signature of the concerned NRI) 5