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Acharya Shri Chander College of Medical Sciences & Hospital Complex, N.H. Bypass, P.O. Majeen (ASCOMS), Sidhra, Jammu – 180017 Tele Nos. 0191-2662268, 2662270,2130067  
APPLICATION FORM AND CONDITIONS LAID DOWN FOR THE NRI/NRI WARDS SEATS FOR MD/MS COURSES SESSION-2014 1. INTRODUCTION 1.1 Acharya Shri Chander College of Medical Sciences & Hospital, Sidhra, is located at a picturesque, pollution free hill slope above river Tawi at Sidhra, Jammu. 1.2 The distance of the College and Hospital is 8 Km from Jammu Railway Station, 10 Km from general bus stand, Jammu and 15 Km from Jammu Airport. 1.3 The College is affiliated to the University of Jammu, Jammu. 1.4 The College has been accorded Minority status in J&K State by the J&K Government vide Govt. Order No. 940-HME of 1997, dated 27-10-1997. 1.5 For NRI candidates, application form is available on the website: www.ascomscollege.com. -02- 2. NUMBER OF SEATS Postgraduate Courses have been recognized by Govt. of India, Ministry of Health & Family Welfare (Department of Health) vide order No.U.12012/15/2003-ME(P) dated 19-09-2003. 2.1 In accordance with regulations of the Medical Council of India, the Jammu & Kashmir Govt. vide order No.202-HME of 2004 dated 07-04-2004 has approved two seats as NRI quota vide Jammu & Kashmir Govt. order No. TRB/Res./15/2010 dated 09-08-2010 and SRO No.246 Two seats are available in the below mentioned disciplines for eligible NRI candidates:- S.No Name of Discipline Total 1. MS General Surgery 1 2. MS Anaesthesia 1
3. APPLICATION FORM AND FEE 3.1 Application form can be downloaded from the website of this Institution www.ascomscollege.com. Application form accompanied with a draft for US $ 100.00 or equivalent to Indian currency, complete in all respect must be submitted by 3.00 p.m. on or before 7th March 2014 in the college office of the Director Principal ASCOMS & Hospital, Sidhra, Jammu. The cost of prospectus includes examination fee also and is non refundable.
3.3 Fee: Fee for undergoing MD/MS courses has been fixed vide Govt. order No. 511-HME of 2013 dated 11-09-2013 at US $ 14,500/- per student per year on the recommendation of the Committee for Fixation of Fee Structure of Professional Colleges constituted vide Govt. order No. 149-Edu(Tech) of 20912 dated 23-08-2012.
4.1 Any candidate who himself/herself is NRI or whose parents are NRI is eligible to apply for admission to MD/MS Courses under NRI category. Any candidate who claim to be a ward of the NRI is also eligible to apply provided that he/she falls within the definition of “WARD”.
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4.3 Candidates who have completed the MBBS course from any Institution outside India are required to have passed the examination conducted by National Board of Examination, New Delhi. 4.4 The applicant must have completed satisfactorily one year’s pre-registration compulsory rotatory internship as laid down by the M.C.I. and the University of Jammu for registration as a Medical Graduate. 5. SUBMISSION OF FORMS 5.1 Application forms Nos. 1 to 4 complete in all respects must reach the office of The Director Principal, Acharya Shri Chander College of Medical Sciences & Hospital, Administration Block, Ground Floor, National Highway Bye pass, P.O. Majeen, Sidhra, Jammu-180017, by 3.00 p.m. on or before 7th March 2014. 5.2 Application forms received after the expiry of prescribed date shall not be entertained. 5.3 Candidate must enclose one self addressed Envelopes (4”x9”) affixed with postal stamps for Rs 35/- along with application form. 5.4 4 copies of recent high contrast passport size photograph with light background are required to be pasted in Forms Nos. 1 to 4. Polaroid Photographs shall not be accepted. 5.5 The photograph must be snapped with a placard indicating name and date of taking the photograph of the candidate. The photographs must be snapped on or after 01-02-2014. The name and date on the photographs must be clear and legible. Photograph should be without cap or goggles, however, spectacles are allowed. 5.6 The photographs must be attested by a gazetted officer in such a way that part of signature is on the application form as well as on photograph. Attestation should be done on the bottom part of the photograph so that photograph is not defaced with a clear stamp/office seal on bottom side. 5.7 The photographs should not be defaced. It should be firmly affixed on the application form Nos. 1 to 4 with adhesive (gum/Fevistick) and should not be pinned up or stapled. 5.8 One copy of the unattested photograph of the candidate duly signed by the candidate on its backside must be enclosed separately in small polythene envelope for use in the OMR sheet at the time of test in the examination hall. 5.9 While filing column 7 of the application form and computer sheet, candidate must indicate his/her options preference wise as per the codes in the respective squares. -04-
5.10 The candidate must fill all the forms and forward all these to the Director Principal, Acharya Shri Chander College of Medical Sciences & Hospital, National Highway Bye Pass, P.O. Majeen, Sidhra, Jammu-180017. 6. CERTIFICATES TO BE ATTACHED Attested photocopies of the following certificates be attached with the application forms:
7. COMPLETING OF APPLICATION FORM 7.1 Before filling the particulars in the applications form, candidate must study the condition laid down therein and also go through the relevant notification carefully and thoroughly.
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7.6 The form will also be rejected if any candidate supplies incorrect information and no refund of fee on this account shall be made.
8.3 Candidates will appear in the Common Entrance test at Jammu at their own cost. No candidate will be allowed to appear in the Common Entrance Test without the Admit Card issued by the Director Principal, ASCOMS & Hospital, Sidhra, Jammu-180017. 8.4 Candidates selected for admission in the College will be required to produce a Medical Fitness Certificate issued by a qualified Doctor (Medical Graduate/Post Graduate). 8.5 The waiting list of candidates discipline wise shall also be prepared in order of merit secured by the candidates in Common Entrance Test. 8.6 All disputes in relation to the selection or otherwise shall be subject to the territorial jurisdiction of court at Jammu. 9. CENTRES OF EXAMINATION 9.1 Candidates shall be informed in writing on the admit cards about the Institutions in which their centers have been fixed. 9.2 Centre of examination once allotted will not be changed. 9.3 Candidates shall also have to preserve the admit card till the allotment of seat and completion of selection process. 9.4 Duplicate admit card will be issued only on production of solid evidence for loss of original one and valid identity proof. 10. CONDUCT OF EXAMINATION 10.1 Examination centre will be opened 30 minutes before the commencement of the examination. 10.2 Candidates who do not possess the Admit Card will not be allowed to sit in the examination hall. The card must be shown on demand. 10.3 Candidates are advised either not to carry any material in the examination hall. 10.3 Smoking in the examination hall shall not be allowed. -06-
10.4 The seating plan shall be displayed outside the examination hall. 10.5 No candidate will leave the examination hall before expiry of full time and without handing over the original OMR answer sheet to the invigilator on duty. 10.6 The Common Entrance Test will be conducted as per the Syllabus for MBBS Course prescribed by the University in the following subjects:- Section ‘A’ Subject No. of Questions Anatomy 10 Physiology 10 Biochemistry 10 Pharmacology 10 Pathology 20 Microbiology 10 Forensic Medicine 10 Community Medicine 20 ___
Total 100 Section ‘B’ Subject No. of Questions Medicine 25 Surgery 20 Paediatrics 05 Obstetrics & Gynaecology 05 Ophthalmology 05 Orthopaedics 05 E.N.T. 05 Anaesthesia 10 Dermatology 05 Psychiatry 05 Radio-diagnosis 10 ___ Total 100
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NOTE: The candidate who is NRI/NRI WARDS shall have to produce necessary proof of relationship if applicable in support thereof to the satisfaction of the concerned Admission Committee of College. 10. BANK GUARANTEE Candidates selected to undergo Postgraduate Programme shall furnish a Bank Guarantee for US $ 29,000/- for subsequent 2 years of the 3 years Postgraduate degree course under taken by the candidate to the satisfaction of the Institution, along with first year admission fee, for sum of US $ 14,500/-to be paid to the Director Principal Acharya Shri Chander College of Medical Sciences, Sidhra, Jammu being Annual Fee. The college will realize the bank guarantee in case the candidate leaves the course midstream i.e. before completion of three years. Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 (Application for admission against Foreign Students/NRI/Wards of NRI seats in the College)
2. Father’s Name ________________________________________ 3. Are you a foreigner? (Write Y for Yes and N for No) ___________ 4. Are you a NRI or ward of NRI? (Give details particulars of the NRI person along with A certificate confirming that you are his/her ward). 5. Name of the NRI ________________________________________ 6. Relationship ___________________________________________ 7. NRI’s full postal address: (i) Permanent _______________________________________ ________________________________________________
___________________________________________________ Telephone No. if any ____________________________ Mobile No. ___________________________________ Email address ________________________________ Fax No. _____________________________________ 8. Sex (Write M for Male and F for Female ______ 9. Religion ____________________ 10. Nationality ____________________________ 11. Candidate’s full postal address: (i) Permanent _______________________________________ ________________________________________________ (ii) Correspondence _____________________________________ ___________________________________________________ Telephone No. if any ____________________________ Mobile No. ___________________________________ Email address ________________________________ Fax No. _____________________________________ 12. Place of Birth (a) Country ________________________ (b) State __________________________ (c ) District _________________________ (d) Tehsil _________________________________ (e) Village/Town __________________________ 13. In case the place of birth is outside India, give the following details:- Present Nationality ______________________ Country of your present passport _______________________ Passport valid up to _________________________________ Passport Number ___________________________________ Issuing authority ____________________________________ 14. Category: Please tick accordingly (√) NRI NRI’s WARD 15. Documents submitted for proof of origin ____________________________________________________ ____________________________________________________
To
ASCOMS and Hospital Sidhra, Jammu Subject: Undertaking by the NRI/NRI’s Ward Sir,
_______________________________________ (Abroad) hereby undertake the responsibility of Mr. Ms. ____________________________________ (Candidate). Residing at _______________________________________________________________ ________________________________ (hereby in after called the “student”) for admission to the Postgraduate MD/MS Courses in ASCOMS, Sidhra, Jammu (herein after called the “student”) under NRI seat quota.
I will also be fully responsible for the total financial support including all expenses on academic, living and traveling of the student and I will bear at the same. Date: Yours faithfully Place: _____________________ (Signature of NRI/NRI’s ward) The above declaration is duly attested by legal authority _________________ Name and Signature of legal authority NOTE: This under taking must typed on the letter head giving details of address and must accompanied by the following information of the NRI/NRI’s ward.
Form No. 1 Sr. No._______ Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 APPLICATION FORM FOR NRI CANDIDATES
Application form of Common Entrance Test for admission to NRI/Children of NRI’S/Wards of NRI’S seats in the Postgraduate MD/MS Courses in Acharya Shri Chander College of Medical Sciences & Hospital. Note: Form should be filled in by the candidate with his/her own handwriting with black ball point pen. Roll No. _________________ (To be allotted by the examining body) Note: Photograph should be attested by a Gazetted officer and pasted firmly. 1. Name in block letters
(First Name) (Middle Name) (Surname) 2. Date of Birth D D M M Y Y Y Y 3. Identification mark of the candidate __________________________________________________ 4. Father’s Name in block letters (leave space to indicate different parts of the name)
5. Father’s/Guardian’s Profession: _________________________________________ 6. Sex (M for male and F for Female) 7. Subject Options (Write down subject codes in the given squares) 1st 2nd
Subject wise codes: (General Surgery-03, Anaesthesia-05) 8. Correspondence Address: ___________________________________________________ ___________________________________________________ ___________________________________________________ Mobile/Telephone No. (if any) _____________ Fax No. (if any) _________________________ E mail (if any) ___________________________ -02-
who have done MBBS course from Institutions outside India, their performance at National Board of Examination, New Delhi. 9.(b) I am seeking admission to P.G. Course in the following subjects under NRI quota General Surgery Anaesthesia Please tick the choice (√)
Signature of the Candidate Thumb’s Impressions of the candidate to be put in the space provided below in the presence of attesting authority at the time of filling the form. Right thumb Left thumb
(Seal/signature of the attesting authority*) *If the Seal/Stamp is not clear, the form will be rejected with out assigning any reason For office use only Signature of the scrutiny committee: 1. ___________________________ 2. ___________________________ 3. __________________________ 4. ___________________________ -03- DECLARATION I hereby solemnly affirm that the statement made by me in this application form is true, complete and correct. should it be found on verification or otherwise, before or after the conduct of Common Entrance Test that I have given herein false, incorrect, untrue information in material/particulars. I shall have no objection if my application/candidature is rejected or my consequent selection/admission is cancelled without refund of any fee paid. I also understand that in such an event, the college will be at liberty to take any other action against me as deemed necessary. I agree to abide by the conditions governing the Entrance Test as contained in the relevant Information Brochure.
I have fully read the information furnished by my son/daughter/ward and affirm that the same is true and if it is found that the information is untrue/incorrect, I am liable to criminal prosecution. Date: ___________________ Signature of Father/Guardian
Dated: ____________________ Signature of the Gazetted officer (with designation and clear office seal/stamp)
The candidate is eligible/not eligible to sit in the common entrance examination. Dated : ________________________ Signature of Officer incharge Form No. 2 Sr. No._______ Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 COMPUTER SHEET FOR NRI CANDIDATES
Application form of Common Entrance Test for admission to NRI/Children of NRI’S/Wards of NRI’S seats in the Postgraduate MD/MS Courses in Acharya Shri Chander College of Medical Sciences & Hospital. Note: Form should be filled in by the candidate with his/her own handwriting with black ball point pen. Roll No. _________________ (To be allotted by the examining body) Note: Photograph should be attested by a Gazetted officer and pasted firmly. 1. Name in block letters (leave space to indicate parts of the name)
2. Date of Birth D D M M Y Y Y Y 3. Identification mark of the candidate: _________________________________________________ 4. Father’s Name in block letters (leave space to indicate different parts of the name)
5. Father’s/Guardian’s Profession: _________________________________________
(Write down subject codes in the given squares) 1st 2nd Subject wise codes: (General Surgery-03, Anaesthesia-05) 8. Correspondence Address: ___________________________________________________ ___________________________________________________ ___________________________________________________ Mobile/Telephone No. (if any) _____________ Fax No. (if any) _________________________ E mail (if any) ___________________________ Signature of the candidate Form No. 3 Sr. No._______ Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 ADMIT CARD FOR NRI CANDIDATES
Application form of Common Entrance Test for admission to NRI/Children of NRI’S/Wards of NRI’S seats in the Postgraduate MD/MS Courses in Acharya Shri Chander College of Medical Sciences & Hospital. Note: Form should be filled in by the candidate with his/her own handwriting with black ball point pen. Roll No. _________________ (To be allotted by the examining body) Note: Photograph should be attested by a Gazetted officer and pasted firmly. 1. Name ___________________________________________________________________________ 2. Father’s Name ____________________________________________________________________ 3. Identification Mark of the Candidate ___________________________________________________ 4. Signatures of the Candidate_________________________________________________________ I certify that the candidate has put his/her signatures on this Card in my presence and that he/she is the actual Candidate whose photograph is above on the Card which is duly attested by me. Signature & seal of the Gazetted officer FOR OFFICE USE ONLY The Candidate with the above particulars is eligible to sit in the Common Entrance Test for admission to Postgraduate Course and be admitted to the same at Centre No. ____________ in ______________________________________________________________________________________ ________________________________________________________ (Name of the Institution) The Common Entrance Test is scheduled to be held on _________________________________ at ________________________________ Signature of Officer I/C (Exam) Form No. 4 Sr. No._______ Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 ATTENDANCE SHEET FOR NRI CANDIDATES
Application form of Common Entrance Test for admission to NRI/Children of NRI’S/Wards of NRI’S seats in the Postgraduate MD/MS Courses in Acharya Shri Chander College of Medical Sciences & Hospital. Note: Form should be filled in by the candidate with his/her own handwriting with black ball point pen. Roll No. _________________ (To be allotted by the examining body) Note: Photograph should be attested by a Gazetted officer and pasted firmly. 1. Name ___________________________________________________________________________ 2. Father’s Name ____________________________________________________________________ 3. Identification Mark of the Candidate ___________________________________________________
Note: This attendance sheet shall be presented to the candidate in the Examination Hall at the beginning of the Test for filling in columns No. I to VI. In case the Candidate is absent, the officer incharge of the examination shall write “Absent” in the columns VI.
While filling up the application form, please do not put Thumb Impressions in the space provided below: Left thumb Right thumb
Thumb Impressions of the candidate to be put in the presence of the Superintendent in the Examination centre only. Certified that the entries in this Attendance Sheet and thumb impressions have been made by the candidate in my presence in the Examination Centre. Signature of the Invigilator Signature of the Superintendent Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 ACKNOWLEDGEMENT CARD FOR NRI CANDIDATES Sr. No.___________ Received an application from: _____________________________________________ S/o, D/o ______________________________________________________________ for Common Entrance Test for admission to Post graduate Courses for the session ______ Receipt Clerk
__________________________________________________ __________________________________________________ 
_________________ Pin Code From: Acharya Shri Chander College of Medical Sciences and Hospital Complex, N.H. Way, Bye Pass, P.O. Majeen (ASCOMS) Sidhra, Jammu-180017 Annexure-I UNDER TAKING REGARDING AUTHORIZATION FOR COUNSELING I, _______________________________ son/daughter/wife of Mr. _________________________ aged _______ years_____ months, bearing Roll No. ____________ placed at Rank No. _____________ in the Common Entrance Examination for admission to MD/MS Courses Session-2014, conducted by Association of Private Unaided Medical & Dental College C/O ASCOMS, Jammu do hereby solemnly affirm and undertake that the decision of my authorized representative, Mr./Mrs./Miss_________________________________ __________________________son/daughter/wife of Mr. _________________________________________ aged _____ years, regarding selection/rejection of seat on the date of personal appearance ________________ shall be binding upon me and I shall not have any claim whatsoever, other than the decision taken by my authorized representative on my behalf on _________________. Signature of Candidate _______________________ Name ______________________________________ Roll No. ____________________________________ Rank ______________________________________ Address ___________________________________ AUTHORITY LETTER I, ______________________________ son/daughter/wife of Mr. ____________________________ bearing Roll No. ____________ for Common Entrance Examination for admission to MD/MS Courses Session-2014 do hereby authorize Mr./Mrs./Miss ____________________________________________ son/daughter/wife of Mr._______________________________________________________________ R/O ____________________________ to represent me on ___________ (Date) before the committee for allotment of a seat in MD/MS Courses, Session 2014. The signatures and the photograph of above named Mr./Mrs./Miss _____________________ _____________________are attested below.
Signature of the Candidate ________________________ Name ______________________________________ Roll No. ____________________________________ Rank ______________________________________ Address ____________________________________ _____________________________________ _____________________________________
Signature of authorized ____________________ representative duly attested by the candidate Note:- Signature & Seal of attesting authority should cross over the photographs.
I, __________________________son/daughter/wife of Mr. ________________________ R/O ___________________________________________aged ____ years____ months, filled the Common Entrance Test form on ________________ for MD/MS Courses Session-2014, to be conducted by Association of Private Unaided Medical & Dental College C/O ASCOMS, Jammu do hereby solemnly affirm & undertake that I authorize Mr./Ms. _________________________________________________________ son/daughter/wife of Mr. ________________________________________________________________ R/O _________________________ aged ____________ years _________ months, to collect the Admit Card on my behalf from the office of Director Principal, Administration Block, Ground floor, ASCOMS & Hospital, National Highway Bye Pass, P.O. Majeen, Sidhra, Jammu-180017.
Signature of Candidate _______________________ Name ______________________________________ Roll No. ____________________________________ Address ____________________________________ ____________________________________ ____________________________________
Signature of authorized _____________________ Representative duly Attested by the candidate Note: - Signature & Seal of attesting authority should cross over the photographs. Yüklə 175,67 Kb. Dostları ilə paylaş:
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