Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
For
APPLICATION FORM
Admission to M. Pharm. Programme
2013 - 2014
&
Admission to
Pre Ph. D. Degree Programme 2013 - 2014
(Final Admission 2014 - 2015)
Sponsored by:
Prof. M. R. Yadav
Sponsored by
ALL INDIA COUNCIL FOR
TECHNICAL EDUCATION, NEW DELHI
(A Statutory Body of the Government of India)
Prof. M. R. Yadav
Principal Coordinator, QIP (AICTE)
Pharmacy Department, Faculty of Tech. & Engg., Kalabhavan,
The M. S. University of Baroda, Vadodara-390 001
1.
Code
PDMSB
3.
4.
DPBITR
10.
DIPSAR
9.
DPDVS
8.
KLEPB
7.
JUPTK
6.
JSSCPO
5.
UCPSW
PCPBVP
MCOPSM
Code
Institution (s)
Pharmacology
PCL
Pharmaceutics
PCE
Pharmaceutical Chemistry
PCH
Pharmacognosy
PCG
PPM
JSSCPO
Pharmacy Practice
PHP
JSSCPO, MCOPSM
QUA
Pharmaceutical Bio-technology
PBT
Pharmaceutical Technology/
Engineering
Clinical Research
PHT
PDMSB, JUPTK
CLR
DIPSAR
HDT
PDMSB
Pharmacy Management
PHM
MCOPSM
Hospital Pharmacy
HOP
DIPSAR
Applied Biochemistry
ABC
JUPTK
Applied Microbiology
AMB
JUPTK
III (ii). DETAILED LIST OF INSTITUTIONS OFFERING M. PHARM AND Ph. D. (QIP)
WITH SPECIALIZATION, NUMBER OF SEATS AND FEES
(approx. as some of the institutions have not provided the latest data)
College
code
Course
Branch
DIPSAR*
M. Pharm
PCE
PCL
QUA
CLR
HOP
PCH
PCE
PCL
QUA
CLR
PCG
PCE
PCH
PCG
PCE
PCH
PCG
PCL
PCE
PCH
PCG
PBT
PCH
PCG
PBT
PCE
PCH
PCG
PPM
PHP
PCH
PCG
PPM
PHP
PCE
PCH
PCL
PCG
IDP
PCH
PCE
PCG
PCL
Ph. D.
DPBITR*
M. Pharm
Ph. D.
DPDVS
M. Pharm
Ph. D.
JSSCPO*
M. Pharm
Ph. D.
UCPSW*
M. Pharm
Ph. D.
No
of
seats
03
03
01
01
01
01
Total
no. of
seats
10
Eligibility
admission
Date of
Admission
Total Course
Fees Rs
Remarks
B. Pharm
As
per
AICTE
July 2013
*Affiliated to
University of
Delhi
M. Pharm
3
03
03
02
2
2
2
2
02
01
01
01
1
1
1
2
02
02
02
02
08
B.
Pharm**
12th July
2013
M. Pharm
**
20th July
2013
B. Pharm
June 2013
67,500/- * (2,70,00/-+
for 2 years, *10% may
be increased
60,000/-* (1,20,000 per
year) 80% waiver will
be possible
*10% may be increased
28,000/- per semester
30-06-2013
05
M. Pharm
5
B. Pharm
08
M. Pharm
6
--02
02
----2
1
1
1
*Affiliated to JSS
University
** Excluding
University fees.
B. Pharm
*Deemed
University
**60% and 45% for
SC/ST.
Aug 2013
*Kakatiya
University
04
M. Pharm
5
JUPTK*
M. Pharm
Ph. D.
KLEBP*
M. Pharm
Ph. D.
PDMSB*
M. Pharm
Ph. D.
PCPBVP*
M. Pharm
Ph. D.
MCOPSM
*
M. Pharm
Ph. D.
PCE
PCH
PCL
PCG
PHT
ABC
AMB
PCE
PCH
PCL
PCG
PHT
ABC
AMB
PCE
PCH
PCL
PCG
PCE
PCH
PCL
PCG
PCH
PCL
HDT
QUA
PHT
PCH
HDT
QUA
PHT
PCE
PCE
PCH
PCL
PCG
QUA
PCE
PCH
PCL
PCG
QUA
PCE
PCL
PCG
PCH
PHP
QUA
PBT
PHM
PCE
PCL
PCG
PCH
PHP
QUA
PBT
PHM
B.
Pharm**
10
10
12
12
02
02
02
02
1
1
--1
01
01
01
01
01
1
1
1
2
1
02
03
01
01
01
2
3
1
1
1
01
01
01
01
01
01
01
01
1
1
1
1
1
1
1
1
June 2013
M. Pharm
**
*University
Department
** First Class B.
Pharm & M. Pharm
without any failure
at any time.
B. Pharm
31-07-2013
M. Pharm
31-07-2013
08
*KLE University
Belgaum
B. Pharm
M. Pharm
First Class
05
16-08-2013
08
B. Pharm
(Minimum
55%)
16-08-2013
As
per
AICTE
B. Pharm
July-Aug
2013
4,18,000/-
08
M.
Pharm**
*University Dept
**Excluding
University Fees
***University
Tuition Fees For
Girls
****University
Tuition Fees For
Boys
*Bharati
Vidyapeeth
University
**Tuition Fees
*Manipal
University
**with Same
Specialization
92,000/-
08
10
Name
Prof. M. R.
Yadav
Prof. K.
Chinnaswamy
Prof. K. R.
Mahadik
Dr. Y.
Narsimha
Reddy
Prof. P.R.P.
Verma
Prof. B. P.
Srinivasan
Dr. A. D.
Taranalli
Prof. Biswajit
Mukherjee
Prof. N. Udupa
10
Prof. G.P.
Agrawal
Address
Contact Number
Mail ID
0265-2434187
FAX 0265-2423898
mryadav@sify.com
0423-2443393
0423-2443847
FAX 0423-2442937
020-25437237
FAX 020-25439383
jsscpooty_qip@rediff
mail.com
Department of
Pharmaceutical Sciences,
Dr. Harisingh Gour
Vishwavidhyalaya, Sagar - 470 003,
Madhya Pradesh.
krmahadik@rediffma
il.com
0870-2438844
(office)
FAX 0870-2453508
0651-2276247
FAX 0651-2275290
prpverma@bitmesra.
ac.in
011-29553771
011-29554327
011-29554649
FAX-011-29554503
bpsrinivasan@yahoo.
com
0831-2471399
FAX 0831-2472387
principal@klepharm.
edu
033-241466771
biswajit55@yahoo.co
m
0820-2922482
0820-2922433
FAX 0820-2571998
FAX 0820-2922762
M: 9845547746
n.udupa@manipal.ed
u
07582-265457
07582-264574
07582-264475
07582-264417
Ext. 126
FAX 07582-264236
gpagrawal2005@redi
ffmail.com
office.cops@manipal.
edu
11
The candidate should satisfy the minimum eligibility criteria prescribed by the individual
department (and/or the Institution) to which admission is sought.
Guest Lecturers, Visiting Lecturers, Teaching Assistants, Ad-hoc/Contract or Part-time
Teachers, Technical Assistants and other such categories of staff are not eligible.
3. Faculty members of the QIP Cells are not eligible to apply in the same institution.
4. The faculty member belonging to the institution run by the same management of QIP Centers are
not eligible to apply to that QIP Centre.
5. A maximum of two candidates are selected from each institution per year, one in M. Pharm. and
one in Ph. D.
6. The candidate, if selected and admitted, should be on deputation and his/her normal salary and
allowances are to be paid by the parent institution.
7. The candidate selected for admission under QIP will have to execute an undertaking to serve his/her
parent institution for a minimum period of three years after completion of the programme.
VI. CONDITIONS FOR ADMISSION
1. The final admission of the candidate will be subject to the clearance and approval by the admissions
wing (section) of the concerned institution as per its rules and regulations in force at the actual time
of admission.
2. The candidate, if selected, should be:
a) Relieved to join the programme in time for the session for which he/she will be admitted,
b) On deputation once admitted and his/her normal salary and allowances are to be paid by the
parent institution.
3. Conditional recommendation by the Principal/Head of the institution will not be accepted.
4. The Principal/Head of the institution of a candidate who is selected for admission should ensure that
Sponsorship Certificate is produced by the candidate at the time he/she joins course from the
management.
VII. APPLICATION PROCEDURE AND GENERAL ISTRUCTIONS
1. (a) Four sets of application forms and the check list should be duly filled in and sent together with
the enclosures to:
13
Preferably by Registered Post or Courier Service, so as to reach his office on or before 15th
June 2013 Applications received after this date will not be considered.
(b) All the forms and the enclosures should be sent only to the Chief Coordinator, QIP.
(c) The proof of delivery issued by the communicating organization is the acknowledgement.
No separate acknowledgement will be issued.
(d) Before mailing the completed forms, please ensure that application form and its enclosures are
properly fastened with a tag or twine at the left hand top corner.
2. For candidates belonging to SC/ST category, an attested copy of the caste certificate in prescribed
format and issued by a competent authority as per the Government of India rules must be enclosed.
3. For candidates belonging to the physically challenged category, an attested copy of the certificate
in prescribed format and issued by a competent authority as per Government of India rules must be
enclosed.
4. Signature of the Principal/Head of your college is required on the application form (Item # 14)
5. Applications submitted without signatures of the appropriate authorities, and/or without all
the required enclosures will automatically become invalid.
6. An e-mail-Id is mandatory for all correspondence.
VIII. ADVANCE ADMISSION SCHEME FOR PH.D. PROGRAMME
As per the admission scheme for pre-Ph.D. programme under QIP, a candidate will receive admission
during 2012-2013 sessions to the Pre-Ph.D. programme and on successful completion of this programme
will be offered admission to the regular Ph.D. programme during 2013-2014. During the one year period
of the Pre-Ph.D. programme the candidate is required to make a maximum of four visits to the institution
(to which he/she is offered admission) covering for a total period of sixty days, to decide on the area of
research, to identify guide and to start preliminary work. During this period, the candidate is to be treated
as on deputation by the sponsoring institution. TA/DA for the visits would be borne by the Institute
where the admission is offered, subject to the actual receipt of the grants from All India Council for
Technical Education. The question of final offer for admission will be considered during May-July 2014,
based on the performance of the candidate during the period of Pre-Ph.D. admission. It is mandatory for
the Non-GPAT/GATE candidate to qualify PET examination before registration.
IX. SCHOLARSHIP AND CONTINGENCY GRANT
M. Pharm.
Ph. D.
Scholarship
Contingency -
Scholarship
Contingency -
14
Pharmacy Department,
Faculty of Tech. & Engg., Kalabhavan
The M. S. University of Baroda,
Vadodara- 390001, Gujarat.
Phone no. : 0265-2434187
Schedule of interview dates will be 24th & 25th June, 2013. TA/DA WILL NOT be paid
for attending the interview.
3. Reporting for interview will be at 10 a.m. on 24th June 2013.
4. Final selection will be made by the QIP Coordinators committee for pharmacy. Selection letters will be
sent by the office of the Principal Coordinator, QIP (Pharmacy) Nodal Center.
5. All original certificates should be produced for verification at the time of interview.
XI.
15
Item
Downloading of Application Forms
Date
20th April 2013
Date of interview
16
with your
signature
across it.
Name
2.
Fathers Name
3.
17
5. Personal Data
Date of Birth
DD
MM
YY
Age
Sex
(M/F)
Category
( GEN/OBC/SC/ST )
Physically Challenged
( Yes / No)
E-mail Address
Telephone No.
(O)
(Mob)
6. Academic Data: Please list in following format on a separate sheet, details of your academic career
starting from graduation (entering each semester/year separately) and attested copies of relevant mark
sheets and certificates. Please convert the grades, wherever applicable, into percentage and write.
Exam Passed
University/Institute
with address
Month/Year
of
Completion
Class, Marks
obtained/
Total marks
Overall
% of
Marks
X Std
XII Std
D. Pharm.
B. Pharm.
M. Pharm.
------------------(Specialization)
18
7. Employment Data: Please list in the following format on a separate sheet the details of employment
(including the present one) and attach attested copies of relevant certificates.
Name of the
Institution
Designation
From
To
Duration
Y/M/D
1.
8. Permanent Teaching Experience as on the last date of application submission: Please enclose a
certificate from the Principal/Head of your Institution (Mention the subjects handled):
9. QIP/ISTE/AICTE/IMPACT Short term Courses Attended: Please list on a separate sheet and
enclose attested copies of relevant certificates.
10. Research Papers: Please list on a separate sheet and enclose a photo copy of each of the published
papers.
11. Industrial/ Research Experience: Please list on a separate sheet and enclose copies of relevant
certificates.
12. Additional Academic Qualification Acquired/Special Distinctions/Awards etc: Please list on a
separate sheet and enclose copies of relevant certificates.
The filled in application form, the data sheet, the check list, complete in all respects, along with all the
enclosures should be sent to:
The Chief Coordinator QIP (AICTE)
Pharmacy Department
Faculty of Tech. & Engg., Kalabhavan
The M. S. University of Baroda,
Vadodara- 390001
Phone no. 0265-2434187
19
13.
Declaration:
(a)
(b)
(c)
(d)
(e)
(f)
I declare that all the information given by me in this application form is correct to the best
of my knowledge and belief, and I understand that false or incomplete information would
cause invalidation of my application.
I shall abide by the decision of the QIP Coordinators Committee for pharmacy in all
matters pertaining to admissions; the decision of the committee shall be final and binding
on me.
I shall abide by the rules and regulations of the institution to which I will be offered
admission, if selected.
Out of the institutions offering admissions under QIP I shall never have any concern
whatsoever for any purpose, with any institution other than the one in which I will be
offered admission, if selected.
For all legal actions, suits and proceedings, the jurisdiction of a court of law shall be
deemed to lie exclusively at the place at which the institution to which I am admitted (if
selected) is situated or the place where the office of the Principal QIP Coordinator, is
located for the time being as applicable i.e. Vadodara, and at no other court or place.
I understand the contents of this form particularly this declaration being made here.
Place :
Date :
20
(e) The applicant is working in our college from__________ (month) _________ (year), teaching to
D. Pharm./B. Pharm./M. Pharm. Students in the subjects_______________
(f) The applicants experience in the college is mentioned in AICTE, PCI and
University inspection forms.
Date:
Signature of the Principal/
Head of the Institution
(Office Seal)
Note:
(a) This forwarding Note should be signed only by the Principal or Head of the Institution (in case of
private colleges after obtaining Permission from management)
(b) Conditional recommendation will not be accepted.
(c) Any alteration made in the forwarding note will lead to automatic rejection of the application.
_______________________________________________________________________________________
15. Institutions and Disciplines to which admission is sought, in order of your preference (use codes
Specialization
Choice-I
Choice-II
I-Preference:
____________
_____________
____________
II-Preference:
____________
_____________
____________
III-Preference:
____________
_____________
____________
Whether you are willing to undergo the study at any other institution than mentioned above, if selected:
Yes/No_________
21
Annexure I
SPONSORSHIP AND RELIEVING CERTIFICATE
working as
22
Annexure II
SERVICE BOND
I
__________________________________________________Asstt.Professor/Assoc.Professor/Professor,
department
of__________________________________
working
in
__________________________________
College of Pharmacy, hereby execute a bond to serve___________________________________
College of Pharmacy for a minimum period of three years after completion of M. Pharm./Ph. D.
Programme under QIP in Pharmacy sponsored by AICTE.
Duly signed
________________________________________
by me
1. _________________________________________________________
2. __________________________________________________________
23
Annexure III
UNDERTAKING
selected
to
in
do______________
Signature of candidate
In presence of:
(Witness)
1. ______________________________________________________________
2. ______________________________________________________________
24
25