Front Page - Acharaya Shri Chander BROCHER … · Web viewBefore mailing/submitting the Application Form to the Director Principal Administration Block, Ground Floor, Acharya Shri

IMPORTANT DATES

1. Date of Downloading of the Information Brochure-Cum-Application Forms for admission to the MD/MS Courses (NRI Quota) Session- 2016 submitted alongwith Demand Draft from Jammu & Kashmir Bank Ltd. or any other Nationalized Bank.

24th February, 2016

2. Last date for the Downloading of the Information Brochure-Cum-Application Forms for admission to the MD/MS Courses (NRI Quota), Session-2016.

12th March, 2016

3. Last date for receipt of the duly filled-in Application Forms at the office of the Director Principal, ASCOMS & Hospital, along with fee amount equivalent to US Dollars 100 payable in the Name of Director Principal, ASCOMS, Sidhra, under J&K Bank account No. 1213040100000229.

18th March, 2016 up to 3.00 PM

4. Issuance of the Roll Nos./Admit Cards to the eligible candidates through Speed Post/Registered Post.

22nd March, 2016

5. Date of the COMMON ENTRANCE TEST. 03rd April , 2016

6. Uploading of the Code Key on the website of the APUMDC of J&K: www.apumdc-jk.com

03rd April, 2016 (Evening).

7. Complaints regarding the Code Key up to * 04th April, 2016 till 8.00 PM

8. Tentative date of the Declaration of Result/ Merit List, including First Select List and Waiting List.

07th April, 2016

9. Selected Candidates must join the allotted specialization, Within Ten days after the Notification of the Select List.

10. In case of any vacancy, due to any reason, the Candidate(s) from the Waiting List shall be upgraded in order of merit and the Candidates so upgraded must join the allotted specialization.

Within Ten days after the Notification of the upgraded List.

11. Date of commencement of the Academic Session-2016-17. 1st May, 2016

12. Last date up to which the Candidates can be admitted to the MD/MS Courses, against the left over seat(s) due to any reason.

31st May,2016

*The complaints regarding the Code Key by the Candidates shall only be entertained on the e-mail id: [email protected]. Please also mention the Name, Question Booklet Series and the specific Question Number(s). No complaint shall be entertained through any other mode/medium as well as after the stipulated period and given time.

CHECK LIST

Before mailing/submitting the Application Form to the Director Principal Administration Block, Ground Floor, Acharya Shri Chander College of Medical Sciences & Hospital, Sidhra, Jammu-180 017, a candidate must ensure that:

1. All the relevant columns of the Application-Form, have been filled-in carefully, neatly and properly by the candidate in his /her own handwriting with Black Ball Point Pen,

2. The Application-Form has been signed by the Candidate, with the thumb impressions in the columns, provided and attested by a Gazetted Officer. Attestation of the Photograph of the Candidate, is in such a way that the half of the Signature is on the bottom part of Photograph and other half on the Application Form, with clear Name & Stamp of the Attesting Authority.

3. Do not put thumb impressions on Form No.4 i.e. Attendance Sheet. Thumb impressions, on the Form No.4, are to be put in presence of the Superintendent in the Examination Hall. Any thumb impression, put on the Attendance Sheet of the Application Form, shall lead to the rejection, without assigning any reason.

4. Application Form, duly filled in and complete in all respects along with Acknowledgement Card, is placed in the envelope, as prescribed.

DATE & TIME OF THE TEST

(i) Examination Centre : As per the Admit Card(ii) Date of the Entrance Test : 3rd April, 2016(iii) Entry in the Examination Hall : 8.00 a. m(iv) Time of the Entrance Test : 9.00 a. m to 12.00 Noon(v) Duration of the Test : 3 hours

Note: The Admit Cards, bearing ROLL NUMBERS & information about the CENTRE OF THE TEST , shall be dispatched only to the eligible Candidates , through Speed- Post/Registered Post, on the address, mentioned on the Envelope (4"×9"), attached with the Application Form,

ACTIVITY SCHEDULE OF THE EXAMINATION DAY

8.00 a.m Reporting time in the Examination Hall on 3rd April, 2016. 8.15 a.m The Invigilators shall ascertain the identity of each Candidate by

comparing his/her facial appearance with the Photograph and Identification Mark mentioned in the Admit Card and the Attendance Sheet. The Superintendent of the Examination Hall shall also check the identity of the Candidates and ensure that only genuine/ bona-fide, Candidates have been allowed to sit in the Examination Hall and there is no impersonation.

8.45 a.m. The Candidates shall be provided the OMR Answer Sheets. They shall go through the instructions, given on the back side of the Carbonless Copy of the OMR Sheet and also fill in the particulars there on the Original Copy of the OMR Answer Sheet.

8.55 a.m. The Candidates shall be given Question Booklets. The Question Booklet Number and its Number Series are to be entered on the OMR Answer Sheet, also.

9.00 a.m. The Candidates shall open the seal of the Question Booklet and start attempting the Questions.

12.00 Noon Paper ends; the Candidates to fold the OMR Answer Sheet at perforation and then tear. Return the Original Copy of the OMR Answer Sheet to the Supervisory staff and carry the Carbonless Copy of the OMR Sheet and Question Booklet, along. Leave the Examination Hall only when you are asked to do so.

Note: - After distribution of the OMR Answer Sheets no Candidate shall be allowed to leave the Examination Hall before 12.00 noon under any circumstances.

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-20161. 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.

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2. NUMBER OF SEATSPostgraduate 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 Total1. MS General Surgery 12. MD Anaesthesia 1

The selection under NRI category is based on merit obtained in the CET conducted by Association of Private Unaided Medical & Dental Colleges in J&K. NRI applicants will have to appear in this CET and would have to qualify with aggregate 50% marks to be eligible for selection in order of merit which would be determined separately for NRI applicants. However, in terms of the guidelines of Supervisory & Monitoring Constitutional Permanent Committee meeting held on 21st May, 2014 in the office of Hon’ble Chairman, at Srinagar, it was inter-alia decided to incorporate the following:

NRI Quota:

The Candidates applying for admission under NRI Quota, to MD/MS Courses, Session -2016, need not to apply for admission under Management Quota, separately, as they shall be considered against the Management Quota (General Quota) as well, if they fall within the merit.

In case of non availability of the NRI Candidates, vacant seats, shall be reverted back to the general pool. The Institution, shall invite the Applications from the eligible candidates out of the merit list of the CET, conducted by the Association, by advertising it in the local Newspaper, and shall admit the candidates in order of descending merit. Such selected candidates, shall be required to pay the fee, equivalent to the fee, prescribed for the NRI Seat in Indian currency.

The preference wise criteria for admission under NRI Category shall be, as follows:

i) Actual NRIs, originally from the state of Jammu & Kashmir only.ii) Children/Wards of the NRIs of the Jammu & Kashmir State only.iii)Actual NRIs, who originally belong to any Indian State or Union Territory, other than J & K. iv) Children/Wards of NRIs, who originally belong to any Indian State or Union Territory other than J & K State.

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 12th March 2016 in the college office of the Director Principal ASCOMS & Hospital, Sidhra, Jammu. The cost of prospectus includes examination fee also and is non refundable. (Demand Draft has to be in favour of Director Principal, ASCOMS, Sidhra, Jammu.)

http://www.ascomscollege.com/

3.2 The period of study & training for the MD/MS Course, shall be Three years as a Post Graduate Student after registration of the Candidate with the University of Jammu.

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3.3 The Statutory Committee for fixation of Fee Structure of the Professional Colleges of the J&K (constituted vide Govt. Order No. 149-Edu (Tech.) of 2012, Dated, 30.08.2012) has approved the Fee to be charged for academic year 2016, vide order No. PS/FSC/27/2015 dated 09-02-2016 in respect of the MD/MS Courses in ASCOMS, Sidhra, Jammu, is as mentioned below:-

No. of Seats Fee Structure02 NRI Seats US Dollars 21750

(Twenty one thousand seven hundred and fifty Dollars) per student per year

3.4 The Candidates who have done Post Graduate Diploma Course of Two years shall also have to pay the full Fee for the Three Years, as mentioned above, if they seek admission in ASCOMS & Hospital, Jammu to pursue the MD/MS Course.

3.5 The students enrolled for P.G. Courses, shall be paid a stipend per month as per norms.

BANK GUARANTEECandidates selected to undergo Postgraduate Programme shall furnish a Bank Guarantee for an amount equal to balance fee of 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 $ 21,750/-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.

4. ELIGIBILITY

Category-I

NRI means any candidate who himself or herself is a NRI or whose parents are NRI is eligible to apply for admission to MD/MS Courses under NRI quota.

Category-II

Candidates financially supported by NRI are also eligible to apply for selection under NRI Category. The NRI supporting the candidate for selection under NRI category-II shall be in blood relation (i.e.) Father, Mother, Brother, Sister, Uncle and Aunt.

4.1 The applicant must have passed the MBBS degree with aggregate marks not less than 50% from any recognized University or an equivalent degree recognized by the University of Jammu and the Medical Council of India and should be registered with the State Medical Council/Medical Council of India with minimum of 50% marks.

4.2 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.

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4.3 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 18th March 2016.

5.2 Application forms received after the expiry of prescribed date shall not be entertained.

5.3 Candidate must enclose two 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 01-02-2016. 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 filling 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.

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.

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6. CERTIFICATES TO BE ATTACHEDAttested photocopies of the following certificates be attached with the application forms:6.1 MBBS degree certificate obtained by the applicant from a University,

recognized by the University of Jammu and the Medical Council of India.

6.2 Registration Certificate of State Medical Council or the Medical Council of India.

6.3 The student who has qualified MBBS from other countries must give details of the Institution, marks obtained, total marks and grade obtained. Student must have passed the test conducted by National Board of Examination, New Delhi, India for recognition of his/her degree by MCI (Candidates must attach the certificate of marks obtained in the National Board of Examination, New Delhi).

6.4 Marks sheets of 1st professional, 2nd professional, Pre-Final and Final MBBS examinations.

6.5 Compulsory Rotatory Internship Certificate issued by the recognized University.

6.6 Date of birth certificate (Matriculation, Secondary School examination certificate from Board/University (attested copy only).

6.7 Documentary proof of NRI (Citizenship/P.R Card etc.), i.e. establishment of relationship. Passport of NRI (Scan copy).

6.8 NRI status certificate of the Financial Supporter issued by the Embassy of respective country under their seal.

6.9 NRI Bank Account Pass Book of the Financial Supporter.

6.10 Passport of the Financial Supporter.

6.11 Nationality Certificate of the Financial Supporter.

6.12 Family Tree (i.e. Pedigree Table) showing relationship with the candidate.

6.13 The applicant shall have to produce the original certificates before the admission committee of college at the time of admission. If during scrutiny or anytime thereafter any discrepancy or incorrectness is noticed, the admission is liable to be cancelled forthwith. The candidate could be expelled and criminal action shall be initiated against him.

7. COMPLETING OF APPLICATION FORM7.1 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.

7.2 All particulars be written by the candidates in his/her own handwriting.

7.3 Candidates are advised to give their Mobile & landline Telephone numbers, Email and Fax number if any, for speedy communication.

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7.4 For making all entries use double-digit numbers from one to nine such as 01,02,03,04,05,06,07,08,09.

7.5 The candidate must fill all the forms i.e. Application form, Computer Sheet, Attendance Sheet, Admit Card and Acknowledgement and forward to the Director Principal, ASCOMS & Hospital, Sidhra, Jammu-180017.

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. MODE OF SELECTION8.1 The test shall be conducted at specified center at Jammu City only.

8.2 Admit Card will be issued to eligible candidates through speed post/registered cover only on 22-03-2016 from the office of Director Principal, Administration Block, ASCOMS & Hospital, Sidhra, Jammu-180017.

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 Government Doctor.

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 EXAMINATION10.1 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.

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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 QuestionsAnatomy 16Physiology 16Biochemistry 12Blood Transfusion Medicine 06Pharmacology 21Pathology 21Microbiology 21Forensic Medicine 12Community Medicine/PSM 25

___Total 150

Section ‘B’Subject No. of QuestionsMedicine 25Surgery 25Paediatrics 19Obstetrics & Gynaecology 20Ophthalmology 10Orthopaedics 10E.N.T. 10Anaesthesia 10Dermatology 05Psychiatry 06Radio-diagnosis 10

___Total 150

Total number of Questions (Paper-I + Paper-II) = 300

10.7 The Common Entrance Test shall be of three hours duration.

10.8 The Question Paper Booklet shall have two sections viz. ‘A’ and ‘B’ as indicated above.

10.9 The total number of marks will be 300 i.e. one mark for one question.

10.10 The candidate will fill in the required particulars in the question booklet and the OMR answer sheet before attempting the questions.

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10.11 The candidates do not have to write answer or mark them in the question booklet. They will select the correct/most appropriate answer for each question and darken the option number in the circle provided against the specific question number in the answer sheet with a black ball point pen to be provided by the Association in the Examination Hall.

10.12 For each correct answer the candidate will get one mark. There shall be no negative marking.

10.13 Any rough work to be done by the candidates, only on the rough sheets attached with the question booklet.

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.

Acharya Shri ChanderCollege 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)

1. Name of the student ____________________________________

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 _______________________________________

________________________________________________

(ii) Correspondence _____________________________________

___________________________________________________

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 WARD15. Documents submitted for proof of origin

____________________________________________________

____________________________________________________

(Signature of Candidate)

FORMAT OF UNDERTAKING LETTER FOR NRI/NRI’s WARD POSTGRADUATE MD/MS COURSES

(Attested by legal authority)

To

The Director PrincipalASCOMS and Hospital Sidhra, Jammu

Subject: Undertaking by the NRI/NRI’s Ward

Sir,

I, ______________________________ NRI/NRI’s Ward residing at ____________________________________________________ (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 hereby agree, affirm and declare that if the student is granted admission, I agree and undertake to pay the fees as would be determined by the competent authority in NRI on the date of admission and further undertake due compliance with fee structure and other associated rules and regulations of the College. I also agree to undertake to pay the prescribed fees for each term if the study is prolonged beyond the normal prescribed duration.

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(Under Proper seal)

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.

NRI status certificate of the Financial Supporter issued by the embassy of respective country under their seal.

Complete introduction of the Parent/Guardian Indian passport number Residence Certificate/permanent residence card Family Tree (i.e. Pedigree Table) Confirming relationship with the ward

NRI Bank Account/Statement of Financial Supporter Employment Certificate of Financial Supporter Copy of Income Tax filed In INDIA showing the status under provision of

Sec.6 of Income Tax Act 1961 of NRI.Form No. 1 Sr. No._______

MD/MS CoursesAcharya 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

(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. (a) Father’s/Guardian’s Profession: _________________________________________

(b) PAN Numbers of Parents ______________________________________________

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: (MS General Surgery-03, MD Anaesthesia-05)

8. Correspondence Address: ___________________________________________________

___________________________________________________

___________________________________________________

Space for high contrast passport size photograph

duly attested by a Gazetted officer to

be pasted depicting name

and date of taking the photograph

Mobile/Telephone No. (if any) _____________ Fax No. (if any) _________________________

E mail (if any) ___________________________

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09. (a) Performance at the Qualifying Examination:

a. IIn case studentswho have doneMBBS 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

MS General Surgery MD Anaesthesia Please tick the choice (√)

b. Internship DetailsDate Name of the College/Hospital

From To

Signature of the Candidate

Thumb’s Impressions of the candidate to be put in the space provided below in the presence of attestingauthority at the time of filling the form.

Right thumb Left thumb

Class Name of Institution

Name of University

Year of passing

Max Marks

MarksObtaine

d

% age Grade

1st Prof.

2nd Prof.

Pre-Final Prof.Final Prof.

(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 onlySignature of the scrutiny committee:

1. ___________________________ 2. ___________________________

3. __________________________ 4. ___________________________

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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.

Dated: ________________________ Signature of the candidate

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

Profession _______________

I hereby certify that the information furnished by the aforesaid candidate is correct as per my personal knowledge.

Dated: ____________________ Signature of the Gazetted officer(with designation and clear office seal/stamp)

List of enclosures attached with the application form (Attested photo copies only)

1. ____________________________________________________________________

2. ____________________________________________________________________

3. ____________________________________________________________________

4. ____________________________________________________________________

5. ____________________________________________________________________

________________________________________________________________________

FOR OFFICE USE ONLY

The candidate is eligible/not eligible to sit in the common entrance examination.

Dated : ________________________ Signature of Officer incharge

Form No. 2 Sr. No._______MD/MS Courses


COMPUTER SHEET FOR NRI CANDIDATES





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. (a) Father’s/Guardian’s Profession: _________________________________________

(b) PAN Numbers of Parents ______________________________________________

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: (MS General Surgery-03, MD Anaesthesia-05)

8. Correspondence Address: ___________________________________________________

___________________________________________________

___________________________________________________

Mobile/Telephone No. (if any) _____________ Fax No. (if any) _________________________

E mail (if any) ___________________________

Signature of the candidate



ADMIT CARD FOR NRI CANDIDATES





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)



ATTENDANCE SHEET FOR NRI CANDIDATES





1. Name ___________________________________________________________________________

2. Father’s Name ____________________________________________________________________

3. Identification Mark of the Candidate ___________________________________________________

4. Signatures 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.

DateI

Name of the CET

II

BookletNumber

III

BookletSeries

IV

OMR Answer sheet number

V

Signature of the CandidateVI





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


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

To

__________________________________________________

__________________________________________________

_________________ Pin Code

From:

Rs 5/- Postal Stamp to be fixed by the Applicant


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-2016, 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-2016 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 2016. The signatures and the photograph of above named

Mr./Mrs./Miss _____________________ _____________________are attested below. Photograph of candidate attested by Gazetted officer

Signature of the Candidate ________________________

Name

______________________________________

Roll No.

____________________________________

Rank

______________________________________

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Signature of authorized ____________________ representative duly attested by the candidate

Note:- Signature & Seal of attesting authority should cross over the photographs.

Annexure-II

UNDER TAKING/AUTHORIZATION FOR COLLECTING THE ADMIT CARD

I, __________________________son/daughter/wife of Mr. ________________________

R/O ___________________________________________aged ____ years____ months,

filled the Common Entrance Test form on ________________ for MD/MS Courses

Session-2016, to be conducted by Association of Private Unaided Medical & Dental College

Photograph of authorized representative attested by the candidate

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 dulyAttested by the candidate

Note: - Signature & Seal of attesting authority should cross over the photographs.

Annexure - III

Undertaking

I, Dr. ______________________ S/O/D/O Sh. ____________________ have applied for MD/MS Course vide Notification No. ASCOMS/DP/CET (NRI)MD/MS/2016/4779, Dated 05.03.2016, hereby declare as under:

1. That, if I am selected against the Management Quota (General Quota) as per the

Photograph of candidate attested by Gazetted officer

Photograph of authorized representative attested by the candidate

terms reference and Govt directions issued on 21.08.2015, my subject choice in the event of my selection against this quota will be as under:

S.No. Subject Subject Code1. _________________________ __________

2. _________________________ __________

3. _________________________ __________

4. _________________________ __________

5. _________________________ __________

Dated._______________ Signature of the Candidate