Ref. No.

M.Phil. in Ocean & CM/.

Yes No

Last date for receiving application 17.8.20011

Received on....

Whether Indian National :

Receiving Assistant....

(Please tick mark in the appropriate box) Percentage of marks obtained in M.A./M.Sc./MCA/B.E./B.Tech. Examination Subject of study at M.A./M.Sc./MCA/B.E./B.Tech. Examination Percentage of marks obtained in Mathematics at 10 + 2 level (Fill in the boxes. Strike out which are not applicable) Sponsored Non-Sponsored (Please tick mark in the appropriate box) SC ST Physically Disabled (PD)

(Please tick mark, if applicable and desired, for reserved category seats. )

Name of the applicant :....

(as in School leaving certificate ) (Use block letters) (Surname) (First Name) (Middle Name)

Affix a recent passport-size photograph duly signed by the applicant

Address for correspondence :

(Use block letters) ...... .. PIN: ..., Telephone No...., e-mail ID

Jadavpur University
Application for Admission to the M.Phil.Course in Oceanography& Coastal Management
To The Registrar, Jadavpur University, Kolkata 700 032 Sir, I wish to apply for admission to the 4-Semester M.Phil. Course in Oceanography & Coastal Management I declare that all statements made in the application are true to the best of my knowledge. Any statement made in the application form if found incorrect on scrutiny, will render the application liable to rejection and admission, if granted on the basis of that statement, will stand cancelled. I also pledge that I will ever strive to be true to the noble ideals of the National Council of Education, Bengal, from which Jadavpur University has originated. If admitted, I undertake to abide by all Rules and Regulations of the University as at the time of my admission or as may be altered from time to time. Yours sincerely, . (Applicants Signature in full)

Date: .

For Office Use Only

Marks obtained in Entrance Examination
Written Test
(F.M. converted to 70) Qualified for Viva Voce Not qualified For Viva Voce

Viva Voce
(F.M. converted to 30)

Total
(F.M. converted to 100)

USE BLOCK LETTERS for item no. 1 - 13

1. 2. Applicants Name : .... Address in Full : (i) Permanent Address : ...... , Telephone No.. (ii) Present Address (where communication is to be made) : .... , Telephone No..... 3. 4. 5. Fathers Name : ..... Mothers Name : Guardians Name & Address : .. ., Telephone No. 6. 7. 8. 9. 10. 12. 14. 15. Relationship with Guardian : .. Occupation of : Father....., Mother., Guardian ....

Applicants annual family income : Rs...... Date of Birth (as in school leaving certificate) : .... Sex: ....., 11. Mother tongue : ......,

Place of Birth :..., District., State .., 13. Nationality : .. Whether belong to SC / ST / PD category Yes / No. Full Name and Address of School/College (If yes, then please tick mark the appropriate category.) Percentage of marks/Grade obtained & Division/Class

Record of complete academic career starting from Secondary or Equivalent: Full Name of Examination passed Full Name of Board/University Subjects taken Year of passing

16.

Whether the applicant is a student of this University Yes / No.

If yes, mention the University Registration details :

Number of Year.., Present Department.., Class Roll..... 17. Whether the applicant is now pursuing any Course in any University Yes / No. If yes, give details :

Course :.., University ..., Date of Final Examination... 18. 19. Any other relevant information : ... Particulars of Sponsored Candidate : Name and address of the Organization where employed Designation of the applicant Date of joining Scale of Pay and present Salary per month

20.

Declaration by the father / mother / guardian : (i) I declare that all statements made above are true to the best of my knowledge. (ii) In the event of the applicant being admitted, I undertake to pay his/her fees and other dues to the University if he/she is not sponsored by any Organization.

Date:.

________________________________________ Signature of Father/Mother/Guardian

Declaration of the employer (for sponsored candidates only) I hereby declare that ________________________________________________ is a permanent employee of our Organization, named_____________________________________________ I assure that he/she will be granted necessary leave in order to pursue 4-semester full-time M.Phil. Course in Oceanography & Coastal management at Jadavpur University, if he/she is selected. The sponsorship fees will be paid by my Organization. _______________________________________________ (Signature of the Head of the Sponsoring Organization)

Date :

..

******************************************************************************************************** APPROACH OF JADAVPUR UNIVERSITY TOWARDS RAGGING

Jadavpur University has accepted the guidelines issued by the Honble Supreme Court in connection with the judgement in Civil Writ Petition No.656 of 1998 filed by Vishwa Jagriti Mission Vs. Central Government and Others. The University has also accepted the West Bengal Prohibition of Ragging in Educational Institutions Act, 2000 (W.B. Act XIII of 2000) which, inter alia, contained the following provisions (for detail, The Calcutta Gazette, Extraordinary, published by Authority on Monday, May 29,2000 may be seen): 1. Ragging means the doing of any act which causes, or is likely to cause, any physical, psychological or physiological harm or apprehension or shame or embarrassment to a student, and includes (a) teasing or abusing of, playing practical joke on, or causing hurt to, any student, or (b) asking any student to do any act, or perform any thing, which he would not, in the ordinary course, be willing to do or perform. Prohibition of Ragging (a) Ragging within an educational institution is hereby prohibited. (b) No person shall participate in, abet, or propagate, ragging in any educational institution. Penalty for Ragging (a) Expulsion from the educational institution, if found guilty on inquiry by the Institution against a complaint lodged by any other student. (b) Imprisonment of either description upto two years or fine upto five thousand rupees or both. (c) Any student convicted under 3(b) shall be dismissed from the educational institution in which he/she has been prosecuting his studies for the time being, and shall not be re-admitted to that educational institution.

2.

3.

The University has further accepted in principle that each and every student of the University shall be duty-bound during the entire period of studentship with the University to immediately report to the Dean of Students if any ragging is noticed either in University hostel or in University campus.

DECLARATION AGAINST RAGGING

Declaration and Undertaking by the Candidate

I do hereby declare that I am fully aware of the abovenoted approach of Jadavpur University towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that I shall neither indulge in ragging activities nor shall take part in or subject anyone to ragging.

Declaration and Undertaking by the Guardian

I do hereby declare that I am fully aware of the abovenoted approach of Jadavpur University towards ragging and the statutory punishment to which a student shall be liable if found guilty of ragging and hereby undertake that my ward shall not indulge in any kind of ragging activities nor shall take part in or subject anyone to ragging.

Signature of the Candidate

Signature of the Guardian

Date :

Date : .

For Office Use Only

Note, if any :

Interviewed on .

________________________________ Signature

Date: .

Conducted by ..

May be provisionally admitted to the First Semester Class of M. Phil. Course in Oceanography& Coastal Management
____________________________________________ Signature of the Director, School of Oceanographic Studies

Date : Decision of the Admission Committee . ________________________________________ Signature of the Chairman/Vice-Chairman of the Admission Committee

Date : ..

Admit to the First Semester Class of M.Phil. Course in Oceanography& Coastal Management by/on...

_________________________________________ Recorded in the office Signature ____________________________ Date : . Date : . Secretary, Faculty Council of Science

(For Office Use, During Admission)

Cash Section : Amount Received Rs. Receipt No. .. Date: . Muster Roll Section : Roll Number : .. Admitted on . Signature of dealing Asst..

___________________________________ Signature

__________________________________ Registrar

_____________________________________ Signature

Price Rs. 250.00

COUNTERFOIL

JADAVPUR UNIVERSITY

ADMIT
Affix a duly attested recent passport-size Roll No. M.Phil.(Ocean.CM.)/. photograph of the candidate in the Examination Hall for appearing at the Written Examination for admission to M. Phil. Course in Oceanography& Coastal Management. SRI / SMT. ..... (Name in block letters to be written by the applicant) Date of Examination : .... Hours of Examination : 2.00 p.m. to 4.00 p.m. Venue : . __________________________________ Signature of the candidate
(to be signed during examination)

_________________________________ Signature of the candidate

(to be signed at the time of application)

___________________________________________________ Director, School of Oceanographic Studies

JADAVPUR UNIVERSITY ADMIT

Affix a duly attested recent passport-size photograph of the candidate

SRI/SMT. . (Name in block letters to be written by the applicant) Roll No. M.Phil.(Ocean.CM.)/.. in the Examination Hall for appearing at the Written Examination for admission to M. Phil. Course in Oceanography & Coastal management. Date of Examination Hours of Examination 2.00 p.m. to 4.00 p.m. Venue : .. ___________________________________ Signature of the candidate
(to be signed during examination)

________________________________________ Signature of the candidate

(to be signed at the time of application)

________________________________________________

Director, School of Oceanographic Studies

A self-addressed envelope (25cm x 10cm) should be submitted along with the filled-in Application Form for sending the Admit Card by post.