CANCER INSTITUTE (WIA) COLLEGE OF ONCOLOGICAL SCIENCES Adyar, Chennai 600 020 Please stick a recent color photo here APPLICATION FOR ADMISSION TO BSc. (RADIOLOGY IMAGING TECHNOLOGY) COURSE (Affiliated to the Tamil Nadu Dr MGR Medical University) (2018-19 SESSION) 1 Name in BLOCK LETTERS: 2 Date of birth & Age (in years): (Evidence to be produced) 3 Sex: 4 Nationality: 5 Name, occupation & address of father / mother / husband / wife: 6 a) Complete address to which any communication is to be sent: b) Telephone no. (with code), if any c) Mobile no., if any d) E-mail id, if any. 7 Do you belong to the scheduled caste / schedule tribe / socially & educationally backward classes specified in the Tamil Nadu Education Rules? (Evidence to be produced) BC BCM MBC / DC SC SCA ST
8 Details of handicap, if any: 9 Educational qualification(s): HSC SSCE CBSC ISCE Others 10 Secondary School Leaving Certificate (X Std) Examination: Name & address of the school: Register number: Month & Year of passing: No. of attempts: 11 Higher Secondary Examination: Name & address of the school: MPC / BPC / Others: Register number: Month & Year of passing: No. of attempts: Distinctions, if any:
English Physics Chemistry Biology Subject Maximum marks Marks obtained Percentage Botany + Zoology Mathematics Computer Science (Copies of the SSLC and HSC Mark sheets and TC obtained after the completion of HSC (Academic) or equivalent course to be enclosed) 12 Have you applied for any other course? If so, give details & order of priority: 13 a) Present occupation, if any: b) Official address: c) Are you a deputed candidate? d) If you are a deputed candidate, have you enclosed the necessary communication? e) If you are not a deputed candidate, have you enclosed a No Objection Certificate from the employer? 14 If not employed at present, have you
applied for any job? If so, give details & order of priority: 15 Details of extracurricular activities, if any: 16 Are you addicted to smoking / alcohol / drugs? If yes, give details: 17 Marital status: a) Are you married? b) If married, occupation of spouse: c) Number of children & their age: 18 Have you enclosed two recent conduct certificates (obtained within three months prior to the date of application)? 19 Have you enclosed a recent, color passport-size photograph? 20 Number & date of Demand Draft enclosed: 21 Are you willing to sign the contract and
pay the necessary annual fees, if selected? I,, do hereby solemnly and sincerely affirm that the statements made and information furnished in my application form, as also in all the enclosures hereto submitted by me, are true and complete. Should it however be found that the information furnished therein is untrue in material particulars, I realize that I am liable for criminal prosecution and I will also be liable to forfeit the seat and / or be removed from the rolls of the Institute at whatever stage of study I may be. Place: Date: Signature of the candidate I,, Father / Mother / Guardian of hereby solemnly declare that I am fully aware of the above declaration and the particulars furnished are correct. I declare that if it is found otherwise my ward will be liable to forfeit the seat and also be liable for criminal prosecution. Place: Date: Signature of the Parent / Guardian
Check list of documents to be submitted [please tick the relevant column(s)] S.No. Certificate Yes No Not applicable 1. Proof of Date of birth 2. Proof of address 3. SC/ST/BC/MBC certificate 4. SSLC (or equivalent) mark sheet 5. HSC (or equivalent) mark sheet 6. Transfer certificate after completion of HSC 7. Two recent conduct certificates 8. Recent colour passport size photo 9. Demand draft 10. No objection certificate from present employer 11. If deputed, letter of deputation from concerned authority
Course details CANCER INSTITUTE (WIA) COLLEGE OF ONCOLOGICAL SCIENCES Adyar, Chennai 600 020 BSc. (RADIOLOGY IMAGING TECHNOLOGY) COURSE - 2018-19 SESSION (Affiliated to the Tamil Nadu Dr M.G.R Medical University) PROSPECTUS The course is affiliated to the Tamil Nadu Dr MGR Medical University. The course commences from August 1, 2018. The Medium of Instruction is English. The duration of the course is four years including one year of internship. Eligibility Candidates who have passed the qualifying examinations (Academic Stream) after a period of 12 years of study are eligible to apply. Those who have passed in vocational stream are not eligible. The minimum educational requirements shall be: Passing of Higher Secondary School Certificate Examination (12 years course) (or) Senior School Certificate Examination (10+2) (or) Pre-degree Examination (10+2) (or) an equivalent with 12 years schooling from a recognized Board or University in the following group of subjects: a. Physics, Chemistry, Botany and Zoology (or) b. Physics, Chemistry, Biology or Mathematics with any other subject The minimum percentage of marks is 40%. The minimum percentage of marks for SC / ST candidates is 35% The marks obtained in the qualifying examinations in the relevant science subjects in first appearance and not the improvement marks in +2 examination of any year will be taken in to consideration. Candidates who have submitted mark sheets with GRADES should obtain the mark equivalent certificates from the examination authority and enclose a copy along with their mark sheets. In the case of candidates who have furnished the mark sheets of the qualifying examination only in GRADES the minimum marks of the Grades alone will be taken in to consideration. The candidate who has passed any qualifying examination other than the Higher Secondary Course Examination conducted by the State Board of School Examination, Department of
Government Examinations, Government of Tamil Nadu should obtain an Eligibility Certificate from the Tamil Nadu Dr M.G.R Medical University by remitting the prescribed fees along with application form which shall be downloaded from the University website (www.tnmmu.ac.in), before admission to the course. A candidate should have completed the age of 17 years at the time of admission or would complete the said age on or before 31 st December of the year of admission to the course. The maximum age limit for joining the course is 40 years. General instructions 1. Candidates should send the completed application with all the necessary documents to the Dean, Cancer Institute (WIA), Adyar, Chennai 600 020. In case of candidates in Government service or candidates being deputed by an Institution / Organization, the application should be made through the relevant proper channel. 2. All the entries in the application form must be legibly written by the candidate in his / her own handwriting. 3. An Account Payee Demand Draft dated not earlier than June 03, 2018, in favor of Cancer Institute (WIA), Chennai 20 for Rs. 100/- (Rupees one hundred only) towards Registration Fee should be attached to each application. This fee will not be refunded under any circumstances, whether the candidate is considered for selection or not. Candidates are, therefore, advised to satisfy themselves before applying that they fulfil all the conditions for admission to the course prescribed as per regulations. 4. Xerox copies of the following documents / certificates should be enclosed: Evidence of date of birth and nationality, Community Certificate, if applicable, Mark sheets of the Higher Secondary Course and Secondary School Leaving Certificate Examination, Transfer Certificate obtained after the completion of HSC (Academic) or equivalent courses, Communication from the institution deputing the candidate, if any, No Objection Certificate from the present employer, if any. 5. No document enclosed along with the application will be returned. Only Xerox copies of the certificates should be enclosed. The original certificates should be produced at the time of interview for verification. 6. Two recent conduct certificates (obtained within three months prior to the date of application) from responsible persons (in original) and a recent, color, passport-size photograph should be enclosed along with the application form. 7. The selection of the candidate will be considered only when all the certificates / enclosures are in order. The original certificates once deposited on admission cannot and will not be released to them until they are considered to be no longer required by the Institute.
8. The application with all enclosures securely fastened should be sent by Registered Post with Acknowledgement Due super scribed and addressed as follows: APPLICATION FOR ADMISSION TO BSc. (RADIOLOGY IMAGING TECHNOLOGY) COURSE To DEAN CANCER INSTITUTE (WIA) CHENNAI 600 020 The last date for the receipt of completed applications in the office of the Cancer Institute is June 23, 2018. Applications which are incomplete or without the signatures of the candidate and Parent / Guardian or necessary enclosures and those received after the due date will be rejected summarily without any intimation to the candidate. 9. All candidates should report for Entrance Examination and interview on July 6, 2018 at their own expense. They should be present at the Auditorium, Cancer Institute (Annex), New No 38, Old No 18, Sardar Patel Road, Guindy, Chennai 600 036 (Near Gandhi Mandapam), at 08.30 am on that day. Separate communication will not be sent regarding the place and time of the interview. In the matter of selection, the decision of the Selection Committee shall be final and no appeal shall be entertained on the subject. 10. All candidates in Government service (State or Central) and candidates sponsored by autonomous institutions will be permitted for the interview only if their application is forwarded by the Government or sponsoring authority, as the case may be, officially. Advance copies will not entitle them to attend the interview. They should produce, at the time of interview, a No Objection Certificate from the Government or the sponsoring authority affirming that the candidate will be released for the course if and when selected. 11. Intimation will be sent only to the selected candidates and they should be prepared to join the course immediately on receiving the information of selection. 12. They should register themselves with the Tamil Nadu Dr. M.G.R. Medical University, through the Dean of the Cancer Institute (WIA), by submitting the prescribed application form for registration duly filled, along with the prescribed fee, a declaration in the format to the Academic Officer of the University and all the original documents, within 30 days from the cut-off date prescribed for the course for admission.
Admission to the above course is provisional and subject to the approval of the qualification of the individual candidates and the acceptance of the candidates for registration by the Tamil Nadu Dr. M.G.R. Medical University. Candidates who have not registered on the due date as specified above will not be admitted. Those selected candidates who have passed any qualifying examination other than the Higher Secondary School Certificate Examination conducted by the Government of Tamil Nadu should obtain an Eligibility Certificate from the Tamil Nadu Dr MGR Medical University by remitting the prescribed fees along with application form which shall be downloaded from the University website (www.tnmmu.ac.in). Selection of such candidates is provisional and subject to the final approval of their qualifications by the Tamil Nadu Dr. M.G.R. Medical University. All candidates provisionally selected should undergo a medical examination, to assess the physical fitness of the candidate to undergo the course, prior to final confirmation of selection. 13. University Fees: All candidates have to pay Registration Fee Rs 1000, Library Fee of Rs 500, Sports Fee Rs 100, HSC Marks Verification Fee Rs 150 and Miscellaneous Fee Rs 500, in addition to the cost of Registration Application Rs 100 (Total Rs 2350) to the Tamil Nadu Dr MGR Medical University. They should also pay any other fee levied by the University from time to time. 14. Tuition fee: The tuition fee to be paid by the candidate to the Institute is Rs 12,000 per year. The first year fee should be paid before the candidate joins the course. Dean College of Oncological Sciences Cancer Institute (WIA) Chennai 600 020