Application No.

(for office use only)

APPLICATION FORM
2019-2020
[FULL TIME – GENERAL / 1st SHIFT ONLY]

FOR SEEKING AFFILIATION FOR NEW

POLYTECHNIC COLLEGES /
HOTEL MANAGEMENT AND CATERING TECHNOLOGY
INSTITUTIONS FOR THE
ACADEMIC YEAR 2019-2020
UNDER FULL TIME – GENERAL / FIRST SHIFT ONLY

Name of the Trust / Society :

Name of the Institution :
District :
Category [Polytechnic/HMCT] :
Mode : FULL TIME – GENERAL / 1st SHIFT

Submitted to

The Commissioner of Technical Education,

53, Sardar Patel Road,
Guindy,
Chennai - 600 025.

Telephone Nos. 22351018 / 22350525

 APPLICATION No.
(for Office use)

Date of Submission of the Application : -- --

APPLICATION FORM
APPLICATION FOR SEEKING AFFILIATION FOR THE NEW POLYTECHNIC COLLEGES / HOTEL
MANAGEMENT AND CATERING TECHNOLOGY INSTITUTION FOR THE ACADEMIC YEAR 2019-2020
UNDER FULL TIME - GENERAL / FIRST SHIFT PROGRAMME ONLY

REGISTRATION FEE :
S.No Demand Draft No. Demand Draft Date Bank Amount

Rs. 5,000

 Registration Fee : ` Rs.5,000

 Demand Draft drawn in favour of "Commissioner of Technical Education, Chennai" payable at
Chennai should be enclosed.

NAME AND ADDRESS OF THE SOCIETY / TRUST / COMPANY ESTABLISHED UNDER

01.
SECTION 25 OF COMPANIES ACT 1956
Name of the Trust / Society / Company :
Address of the Trust / Society / Company :

Village / Town :
Taluk :
District :
Pincode :
Assembly Constituency :
Parliament Constituency :
Phone : STD Code: Phone No.:
Fax : STD Code: Fax No.:
Mobile :
E-mail :

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02 (a) NAME AND ADDRESS OF THE INSTITUTION AT THE PERMANENT SITE
Name of the Institution :
Address of the Institution :

Village / Town :
Taluk :
District :
Pincode :
Assembly Constituency :
Parliament Constituency :
Phone : STD Code: Phone No.:
Fax : STD Code: Fax No.:
Mobile :
E-mail :

02 (b) DETAILS OF THE SOCIETY / TRUST / COMPANY

Society Registration Act No. or Trust Act No.
:
or Company Act No.
Registration No. :
Date of Registration :
Place of Registration :

DETAILS OF MEMBERS / TRUSTEES AND THEIR EXPERIENCE IN RUNNING HIGHER

02 (c)
EDUCATIONAL, TECHNICAL OR OTHER PROFESSIONAL INSTITUTIONS ETC.
S.No Name of the Members of the Designation Qualification Experience in running higher
Trust / Society / Company in the Trust / educational, technical or other
Society / professional institutions (in years)
Company

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 TRACK RECORD OF THE APPLICANT IN TERMS OF TECHNICAL / PROFESSIONAL /
02 (d)
NON-PROFESSIONAL INSTITUTIONS RUN / MANAGED BY THE SOCIETY/TRUST
Whether the Trust / Society / Company is
: Yes No
running/managing any educational institutions

If YES, then provide the information as per the table given below.
S.N Name and Year of Whether Discipline Duration Annual Whether
Address of the Establish- Diploma/ conducted of the Intake approved by
Institution ment Degree Course capacity AICTE/Univ./
(UG/PG) UGC/State
Govt./Board/
Other Council

03. DETAILS ABOUT THE CATEGORY OF THE INSTITUTION

Year of establishment :

Category of the Institution : POLYTECHNIC COLLEGE

HOTEL MANAGEMENT & CATERING

(Please tick the appropriate box)
TECHNOLOGY
MINORITY
NON- Linguistic Religious Others
MINORITY (Specify)
Malayalam Telugu Sourashtra Christian Muslim Jain

04. PARTICULARS OF THE HEAD OF THE INSTITUTION [PRINCIPAL]

Name :

Designation :

Qualification :

Mobile :

Phone : STD : Phone No. :

Fax : STD : Fax No. :

E-mail :

05. DETAILS OF THE LANDS [PERMANENT SITE AS APPROVED BY AICTE]

Classification of the Permanent Site : Rural Area

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 (Please Click on any one of the classification) Other than Rural area
Ownership of Land : Government Trust Society
Govt. Leased Owned Company
Details of Land
(The Survey No. with sub-division and extent of lands for each survey number to be indicated)
Sl. Registration Registration Name of the Survey No. with Extent of Land
No Document No. Date village sub-division Lands Classification
. (in acres) [Indicate Dry
or Wet Land]

TOTAL ---
Legal disputes , if any : On Land YES NO On Trust YES NO
If YES, Details

LAND USE CONVERSION

Certificate No.: Date:
CERTIFICATE Details
LAND USE CLASSIFICATION Details Certificate No.: Date:

06.(a) DETAILS ABOUT THE BUILDING OF THE INSTITUTION AT THE PERMANENT SITE

Whether the Building Plan is approved by the

: Yes No
DTCP/competent authority

If YES, then
Name of the authority approved the building plan :
Designation of the authority approved the building plan :
Date of Approval :
Proceedings Number issued by the authority :

06 (b) PHYSICAL INFRASTRUCTURE - COMPLETE DETAILS OF BUILT-UP AREA (R.C.C.)

FIRST YEAR
S. Built-up (Carpet) Area
Required Area Available Area
No [in sq.m] Structure
(R.C.C.) (R.C.C.)
(a) Instructional area [INA] R.C.C.
(b) Administrative area [ADA] R.C.C.
(c) Amenities area [AMA] R.C.C.
TOTAL AREA :

$ -as same as the data provided in the Application uploaded in the AICTE web portal

07. DETAILS OF THE COURSES APPROVED BY AICTE

General / Approved Intake AICTE Approval
S.No Discipline [Course Details] Mode
1st Shift for 2019-2020 Letter No. & Date
01. 1st SHIFT Full Time
02. 1st SHIFT Full Time

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 03. 1st SHIFT Full Time
04. 1st SHIFT Full Time
05. 1st SHIFT Full Time
06. 1st SHIFT Full Time
TOTAL ANNUAL INTAKE

NAME AND ADDRESS OF THE MEMBERS OF THE GOVERNING BODY AS PER THE
08 (a)
COMPOSITION PRESCRIBED BY AICTE
Present
Professional Telephone
S.No Name Position Qualification E-mail Address
position / Numbers
Occupation
01. Chairman
Member
02.
Secretary
03.
04.
05.
06.
07. Members
08.
09.
10.
11.

NAME AND ADDRESS OF THE MEMBERS OF THE ANTI-RAGGING COMMITTEE AS PER

08 (b)
THE COMPOSITION PRESCRIBED BY AICTE
Present
Professional Telephone
S.No Name Position Qualification E-mail Address
position / Numbers
Occupation
01.
02.
03.
04.
05.
06.
07.
08.
09.

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 10.

09 (a) PHYSICAL INFRASTRUCTURE - ONLY FOR FIRST YEAR (As per the details furnished in AICTE web
portal. Requirement as per AICTE application process hand book 2019-2020)
Built-up Built-up
S. Number Number Shortag AICTE NORMS
Category Shortage Area Area
No Required Available e [AREA/ROOM]
Required Available
I. INSTRUCTIONAL AREA Diploma [Engg.]
75% No. of division
1. Class rooms [C] of intake 60 (66 sqm
each)
1 for every 4
2. Tutorial rooms [D] class rooms
(33 sqm )
2 per course (66
sqm each) for I
3. Laboratory year (as per
curriculum
requirement)
01 No.
4. Workshop 1 200 sq.m
[200 sq.m]
Additional 1 per course
5. 200 sq.m
Laboratory (maximum 2)
01 No.
6. Computer Centre 1 150 sq.m
[100 sq.m]
01 No.
7. Drawing Hall 1 132 sq.m
[132 sq.m]
01 No.
8. Seminar Hall 1 132sq.m
[132 sq.m]
Language 01 No.
9. 1 132sq.m
Laboratory [66 sq.m]
Library and 01 No.
10. 1 300 sq.m
Reading Room [300 sq.m]
II. ADMINISTRATIVE AREA
Principal /Director 01 No.
11. 1 30 sq.m
Office [30 sq.m]
01 No.
12. Board room 1 20 sq.m
[20 sq.m]
01 No.[150 sq.m
13. College Office 1 150 sq.m for one
programme]
HOD Cabin and 1 per
1 per Department
14. Department Departm 20 sq.m
(20 sq.m)
Office ent
First
5sq.m for F=Sanc.Inatake /
year
15. Faculty room each 25
student
Faculty [F x 5 sq.m]
intake/25
01 No.
16. Central Stores 1 30 sq.m
[30 sq.m]
01 No.
17. Maintenance 1 10 sq.m
[10 sq.m]
01 No.
18. Security 1 10 sq.m
[10 sq.m]
01 No.
19. House keeping 1 10 sq.m
[10 sq.m]

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 01 No.
20. Pantry for Staff 1 10 sq.m
[10 sq.m]
Exam Control 01 No.
21. 1 30 sq.m
Office [30 sq.m]
III. AMENITIES AREA
Toilets
22. 1 75 sq.m
[Ladies] Adequate
Toilets [150 sq.m]
23. 1 75 sq.m
[Gents]
Boys Common 75 sq.m 01 No.
24. 1
Room [75 sq.m]
Girls Common 75 sq.m 01 No.
25. 1
Room [75 sq.m]
150 sq.m 01 No.
26. Cafeteria 1
[150 sq.m]
Stationary Store 01 No.
27. 1 10 sq.m
& Reprography [10 sq.m]
First Aid cum Sick 01 No.
28. 1 10 sq.m
Room [10 sq.m]
TOTAL ---

IV CIRCULATION AREA = 25% OF SUM OF INSTRUCTIONAL, ADMINISTRATIVE AND AMENITIES AREA

TOTAL ---

09 (b) COMPUTER CENTRE - COMPUTERS, SOFTWARE, INTERNET AND PRINTERS

S. Sanctioned Number of Terminals
Computer Facilities AICTE NORMS
No intake Required Available Shortfall
Sanc.Intake [ S.I]
Computers [S] - S
1. 6
First Year Students only
[Min. 20 PCs]
Multimedia Computers – 1% of Total Students
2. Library / Internet Surfing in Intake
Reading room [Max. 10]
Computers - Exclusive - along with LAN
3. ---
For Faculty Members and Internet over and above
Computers - the requirement meant for
4. --- students
For Administrative Office
5. Printers [P] --- P=S/20
S.I <=300 =32 Mbps
6. Internet Facility --- S.I >300 to 600 = 48
Mbps
7. LAN Facility YES / NO : All
8. Legal System Software --- 03
List of System Softwares (01).
(02).
(03).
9. Legal Application Software --- 20
List of Application Software

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10. Computer Table / Chair No. of Computer Tables :
No. of Computer Chairs :
11. Air Conditioners YES / NO :
12. Central Xerox Facility YES / NO :
13. Mail Server & Client YES / NO :
14. Computer Specifications
[General, in brief]
Arrangement to view for
15. NPTEL / SWAYAM etc.,

4 MBPS Secured WiFi

16. Connectivity at 4 or 5 Hot
Spot

09.
BOOKS, JOURNALS AND LIBRARY FACILITIES:
(c)
No Description AICTE NORMS Required Available Shortage

1 Number of Titles 50 Titles of Books for whole first Year

Number of 250 volumes of Books for each division

2 Volumes of 60 students

Reading room 15% of Total Sanctioned Student

3. seating capacity Strength [max 150]
Member of
4. National Digital
Library

09 d. GENERAL FACILITIES - ESSENTIAL REQUIREMENTS

S. Availability If YES, then
Description
No [YES / NO] Number Available
1. Standalone Language Laboratory
Potable Water supply and outlets for drinking water at
2.
strategic locations
3. Electric supply

4. Sewage Disposal System

5. Telephone and Fax

2019 - 2020 9|Page

 6. Vehicle parking
Display of information submitted to AICTE (including the
7. accreditation status and Board of Governors) along with
mandatory disclosures in the Website of the Institution
Copy of AICTE approvals (LoA and EoA of subsequent
8. years) obtained since inception of the Institution till date
shall be placed in the Web site of the Institution
Digital Payment for all financial transactions as per MHRD
9.
directives
Compliance of the National Academic Depository (NAD)
10. as per MHRD directives, applicable to PGDM / PGCM
Institutions and University Departments
11. Provision to watch MOOCS courses through Swayam
Display board within the premises as well as in the website
12. of the Institution indicating feedback facility of students and
faculty available in the AICTE web portal
Barrier Free built Environment for Differently-Abled and
13 elderly persons (as per Chapter V of Approval Process
Hand Book 2018-19)
Safety and Security measures in the campus (as per
14
Chapter V of Approval Process Hand Book 2018-19)
Safety provisions including fire and other calamities (Refer
15 Annexures 8 and 9 of Approval Process Hand Book 2018-
19)
Implementing Food Safety and Standards Act,2006 in the
16
Institution
General Insurance provided for assets against fire,
17
burglary and other calamities

18 Road Suitable for use by Motor Vehicle – Motorised Road

19 General Notice Board and Departmental Notice Boards

20 First Aid, Medical and Counselling Facilities

21 Appointment of Student Counsellor

22 Group Insurance to be provided for the employees

23 Insurance for students

24 Institution –Industry Cell

25 Placement Cell

26 Applied for membership of National Digital Library

Establishment of Online Grievance Redressal Mechanism
27 as per Annexure 12 of Approval Process Hand Book 2018-
19)
28 Establishment of Anti Ragging Committee
Establishment of Grievance Redressal Committee in the
29 Institution and Appointment of OMBUDSMAN by the
University
30 Establishment of Internal Complaint Committee

31 Establishment of Committee for SC/ST

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 09.e GENERAL FACILITIES - DESIRABLE REQUIREMENTS
1 Implementation of the schemes announced by MHRD

2 Offering of skill development courses approved by Council

Participation in the National Institutional Ranking
3
Framework (NIRF)
Fabrication facility Laboratory (FABLAB)/ Tinkering
4
Laboratory/ Innovation Laboratory

5 Backup Electric supply

Availability of at least ONE Smart Classroom per
6
Department
Rain Water Harvesting and Installation of grid connected
7
solar rooftops / Power systems
Waste Management and environment improvement
8
measures to ensure a sustainable Green Campus
Public Announcement System at strategic locations for
9 general announcements / paging and announcements in
emergency
Enterprise Resource Planning(ERP) Software for Student-
10
Institution-Parent Interaction
Efforts to encourage Final Year students to appear GATE
11
examination

12 Transport

13 Post Office, Banking Facility / ATM

14 LCD(or similar) Projectors in Classrooms

15 Staff Quarters

Display of courses and ‘Approved Intake’ in the Institution

at the entrance of the Institution. Courses taken through
16
duly recognized MOOCs shall be used as Supplementary
Courses

17 Implementation of Start-up Policy

18 Intellectual Property Right Cell

Implementation of Unnat Bharat Abhiyan / Saansad
19
Adarsh Gram Yojana (SAGY)
Availability of quality sanitary napkins through sanitary
napkin vending machines and ensuring safe and
20
environment friendly disposal of used sanitary napkin
through sanitary napkin incinerator

10. ACADEMIC INFRASTRUCTURE

S. Category AREA [sq.m] Details to be provided, whichever necessary

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 [BB / OHP / LCD]Teaching Aids

Power Connection (Y/N)

Work Table (Nos)

Ventilation (Y/N)
Furniture (Nos)

No. of Lights
Size [ l x b ]

No. of Fans
Available
Required

Capacity
No

1. Class Room 1
2. Class Room 2
3. Class Room 3
4. Class Room 4
5. Class Room 5
6. Tutorial Room 1
7. Tutorial Room 2
8. Laboratory 1
9. Laboratory 2
10. Laboratory 3
11. Laboratory 4
12. Laboratory 5
13. Laboratory 6
14. Laboratory 7
15. Laboratory 8
16. Laboratory 9
17. Laboratory 10
18. Additional Laboratory
19. Workshop
20. Computer Centre
21. Drawing Hall
22. Library
23. Reading Room in Library
24. Seminar Hall
25. Language Lab
26. Principal Room
27. Board Room
28. College Office
29. HOD Cabin 1
30. HOD Cabin 2
31. HOD Cabin 3
32. HOD Cabin 4

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33. HOD Cabin 5
34. Faculty Room 1
35. Faculty Room 2
36. Faculty Room 3
37. Faculty Room 4
38. Faculty Room 5
39. Central Stores
40. Maintenance Room
41. House Keeping Room
42. Pantry for staff
43. Exam Office
44. Gents Toilet
45. Ladies Toilet
46. Boys Common Room
47. Girls Common Room
48. Cafeteria
Stationary Store &
49.
Reprography
50. First Aid cum Sick Room

TOTAL :

REQUIREMENT FOR FIRST YEAR – ALL THE FACULTY & STAFF SHOULD BE ON PAY
ROLL.
Faculty for First year : Faculty : Student Ratio = 1 : 25 – must be computed based on
Sanctioned intake only.

Librarian : One

Physical Education : One

Director
Technical Supporting Staff :
Workshop Instructor one

Skilled / Lab Assistant : Minimum 3 for first year

Administrative Staff (As per : Minimum 3
Institutions requirement )
Basic servants (As per : Minimum 4
Institutions requirement )

FIRST YEAR FACULTY AND STAFF REQUIREMENTS FOR SANCTIONED INTAKE OF

11 (a)
____________
AICTE NORMS &
S.No First year HOD Lecturer TOTAL
GUIDELINES
1. English

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 Mathematics
Physics Faculty : Student
Ratio = 1 : 25
Chemistry
Engineering

TOTAL
(i) TOTAL SANCTIONED INTAKE :
(ii) TOTAL STAFF REQUIRED [at the ratio of 1 : 20] :
(iii) TOTAL STAFF AVAILABLE [ON THE PAY ROLL] - :
(iv) STAFF STUDENT RATIO [BASED ON PAYROLL] - :
Requirement Of Principal, Librarian, Physical Education Director,
Required Available
Non-Teaching Technical And Others
2. Principal : ONE
3. Librarian : ONE
4. Physical Education Director : ONE
5. Non-Teaching Technical Staff : :
WORKSHOP INSTRUCTOR : One
SKILLED / LAB ASSISTANTS (As per requirement) : Minimum 1 for each lab.
UNSKILLED ASSISTANTS (As per requirement) : As per requirement
6. Number of Ministerial Staff : Minimum 3
7. Number of Basic Servants : Minimum 4
8. Whether AICTE Pay Scales implemented : state YES / NO :

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 11 (b)

Photo

Photo
Faculty

2019 - 2020
Stamp Size

Stamp Size
Institution

Name of the

Member with
Date of Birth &
Designation Age

Department
Qualification

Position
Teaching
with Class
obtained starting
from the highest
Qualification with Degree

II. PRINCIPAL - EXPERIENCE

Class obtained
I. PRINCIPAL - QUALIFICATION

starting from the

highest Degree

Years
Corresponding
NAME OF THE PRINCIPAL :

Specialization

III. TEACHING FACULTY - QUALIFICATION

Corresponding
Specialization
Date of Joining
FACULTY - QUALIFICATION AND EXPERIENCE

AgeDate of Birth &

Institution
Scale of Pay
Date of Joining

Scale of Pay Present Basic

Pay
Position
Industry

Present Basic Pay

emolumentsTotal emolumentsTotal
Years

15 | P a g e
Signature
Signature
 IV. TEACHING FACULTY - EXPERIENCE
Teaching Industry
Name of the faculty
S.No
Member Institution Position Years Institution Position Years

V. LIBRARIAN AND PHYSICAL EDUCATION DIRECTOR AgeDate of Birth &

Date of Joining

Present Basic Pay

emolumentsTotal
Qualification with

starting from the

highest Degree
Class obtained

Scale of Pay
Designation

Experience

Name of the
Previous

Faculty Member
Signature
with Stamp Size
Photo
Librarian
DirectorPhysical Education

VI. WORKSHOP AND TECHNICAL SUPPORTING STAFF

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 Date of Joining
ExperiencePrevious

Date of Birth & Age

Present Basic Pay

emolumentsTotal
Qualification

Scale of Pay
Designation
Department

Laboratory

Signature
S.
Name of the Staff
No

VII. MINISTERIAL STAFF

Date of Joining
ExperiencePrevious

Date of Birth & Age

Present Basic Pay

emolumentsTotal
Place of Work

Qualification

Scale of Pay
Designation

Signature
S.
Name of the Staff
No

12 (a) EQUIPMENTS
1. Whether Equipments for all the Laboratories / Workshops prescribed : YES / NO
as per syllabus is available
2. Whether all the existing equipments are entered in Stock Register ? : YES / NO

3. Whether all the existing equipments are in working condition or not ? : YES / NO

4. If not, list out the equipments that are not in working condition : (list to be enclosed)

5. Whether any equipments are likely to be purchased in respect of the : YES / NO

Courses for which extension of approval is applied

6. If YES, list out the equipments - (list to be enclosed)

12 (b) LIST OF EQUIPMENTS AND ITS ADEQUACY [FOR A BATCH OF 30 STUDENTS]

I. FIRST SEMESTER – ENGINEERING PHYSICS – I PRACTICAL [ “M” SCHEME ]

S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
Order has Order
been placed? details
1. MICROMETER (SCREW 4
GAUGE) SETUP - Screw SETS
gauge, graph sheet and
irregular glass plate.
2. VERNIER CALIPERS 4
SETUP - Vernier Calipers SETS
and Solid Cylinder

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 3. CONCURRENT FORCES 4
SETUP - Vertical drawing SETS
board, two Z pulleys, three
sets of slotted weights (5 x
50g) and twine thread
4. COMPARISON OF 4
VISCOSITIES - Burette SETS
stand, graduated burette
without stopper, rubber tube,
beaker, capillary Tube,
digital stop watch and
funnel.
5. STOKES’ METHOD SETUP 4
– Stokes Apparatus, high SETS
viscous liquid (Castrol oil),
glass beads of Different
radii, digital stop watch and
screw gauge
6. SURFACE TENSION 4
SETUP - Beaker with water, SETS
capillary tube, iron stand
with clamp, pointer,
travelling microscope and
hydro static bench.
7. SONOMETER SETUP - 4
Sonometer, screw gauge, SETS
tuning fork, rubber hammer,
slotted weight hanger set (5
x 0.5kg) and paper rider
8. DEFLECTION 4
MAGNETOMETER SETUP - SETS
Deflection Magnetometer,
meter scale and two bar
magnets

II. SECOND SEMESTER – ENGINEERING PHYSICS – II PRACTICAL [ “M” SCHEME ]

S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
Order has Order
been placed? details
1. REFRACTIVE INDEX 4
SETUP - Travelling SETS
Microscope, Beaker with
transparent liquid and Saw
dust
2. SPECTROMETER. SETUP - 4
Spectrometer, Sodium SETS
vapour lamp, Reading lens
and Glass prism
3. SOLAR CELL SETUP - 4
Solar cell Kit for drawing the SETS
V - I characteristics

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 4. LAWS OF RESISTANCES - 4
Battery Eliminator, key, SETS
rheostat, ammeter,
voltmeter, Connecting wires
and two known standard
resistances
5. JOULE’S CALORIMETER 4
SETUP- Joule’s Calorimeter, SETS
Battery eliminator, Rheostat,
Key, Ammeter, voltmeter,
stop clock, thermometer,
digital Balance and
connecting wires
6. COPPER VOLTAMETER 4
SETUP- Copper Voltameter, SETS
Battery eliminator, Rheostat,
Key, Ammeter, stop clock,
digital balance, emery sheet
and Connecting wires
7. P-N JUNCTION DIODE 4
SETUP - P-N Junction Diode SETS
forward characteristics kit
8. LOGIC GATES SETUP - 4
Logic gates testing SETS
apparatus kit with bread
board for Mounting ICs and
Integrated circuit chips ( IC
7404 – NOT Gate, IC 7408 –
AND Gate, IC 7432 – OR
gate, IC 7400 – NAND Gate,
IC 7402 – NOR Gate)

III. I & II SEMESTER – ENGINEERING CHEMISTRY – I & II PRACTICAL [ “M” SCHEME ]

S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
(in Nos) Order has Order
been placed? details
Non-Consumable Items:
1. LPG gas Connection (DBC) 1

2. Exhaust Fan (High capacity) Sufficient

3. Fire Extinguisher 1
4. First Aid Box (Full set) 2
5. Safety chart 1
6. Chemical Balance 1
7. Fractional weight box 1
8. pH meters 5
9. Working Table with all 8
accessories
Glassware and Other Items :

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 1. Burette 50ml 35
2. Burette stand 35
3. Pipette 20ml (with safety 35
bulb)
4. Pipette 10ml 5

5. Conical Flask 250ml 35

6. Funnel 3” (Polythene) 50
7. Porcelain Tile 6x6” 35
8. Measuring Cylinder 10ml 5
9. Measuring Cylinder 1000ml 2
10. Reagent Bottle (White) 60
250ml
11. Reagent Bottle (White) 100
125ml
12. Reagent Bottle (Amber) 80
250ml
13. Test tubes 15 x 1.5 mm 1000
14. Test tubes 15 x 2.5 mm 500
15. Test tube stand 35
16. Test tube holder 35
17. Test tube cleaning brush 35
18. Glass Trough 5
19. Beakers 100 ml 35
20. Glass Rods 15cm 100
21. Watch Glass 3” 35
22. Wash Bottle (Polythene) 35
1000 ml
23. Nickel Spatula 35
24. Bunsen Burner for gas 30
connection
25. Plastic Buckets (15 lts) 10
26. Filter Paper Round sheets sufficien
t Nos.
27. Standard flask 100 ml 35

IV. SECOND SEMESTER – WORKSHOP PRACTICE [ “M” SCHEME ]

S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
(in Nos) Order has Order
been placed? details
FITTING SECTION
1. 4” Bench vice 30
2. 12” Flat Rough file 30

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 3. 12” Flat smooth file 30
4. 10” Try angular file 30
5. 8” Half round file 30
6. 8” Square file 10
7. 10” Round file 10
8. 150 mm Try square 30
9. 150 mm Steel rule 30
10. 6 mm Dot punch sufficien
t qty
11. 6 mm Center punch sufficien
t qty
12. Hacksaw Frame 30
13. 6” leg vice 5
14. 6 mm Prick punch sufficien
t qty
15. Hand shearing machine 1
16. Ball Pan ½ lbs Hammer 30
17. 6.8 mm Drill Bit 5
18. 8.5 mm Drill Bit 5
19. 10.2 mm Drill Bit 5
20. M8 tap set 5
21. M10 tap set 5
22. M12 tap set 5
23. Drilling machine 3
24. Deep cut Hacksaw frame 5
25. 2’ x 1 ½’ Surface plate 2
26. Scriber 30
27. Tap wrench sufficien
t qty
28. Power Hacksaw/ bar cut 1
machine
29. Surface plate 5
30 Anvil 5
31 calipers 10
32 Vernier Caliper 5
33 Vernier Height Gauge 2

WIRING SECTION
1. 6” Insulated handle cutting 15
pliers
2. 8” Insulated handle screw 30
driver
3. ¼ Pound hammer 30
4. Wire Cutter 30
5. 250V Line Tester 15

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 6. 10 cm Poker 5
7. 4” Connecting Screw driver 30
8. 2 x 1½ Wiring board(wood) 15
9. Multi meter 5
10. Required numbers of Adeq
switches and sufficient
consumables
11 Wire Cutter 10

12 Screw driver 15

13 wires,Tube light set, holders, Adeq

connectors, switches
PLUMBING SECTION

1. Hand operated bending Tool 2

2. Sprit level 5
3. Try Square 5
4. Measuring Tape 5
5. Hand drilling Machine 2
6. Hacksaw Frame with Blade 5
7. Junior Hacksaw frame 5
8. Pipe/tube Cutter 2
9. Water meter 5
10. Cutting Plier 5
11. Grip plier 5
12. Slip Joint Plier 5
13. Screw Driver 5
14. D/E Spanner(6 to 32 mm) 2
15. set Spanner(6 to 32 mm)
Box 2
16. set
Jumper Bit 5
17. Flat Chisel 5
18. Sledge Hammer 5
19. Pipe vice 2
20. Pipe Die Set 5
21. Pipe wrench 5
22. Shifting Spanner 5
23. Wire Brush 5
24. Personnel Protecting Sufficient
Equipments quantity
25. Teflon Tape/ Solution Sufficient
quantity
26. Emery Sheet Sufficient
quantity
27. GI Pipes & Accessories Sufficient
quantity
28. PVC Pipes & Accessories Sufficient
quantity
29. Other Consumables Sufficient
quantity

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 II. GENERAL [COMMON LABORATORIES]
II (A). GENERAL [COMMON] – COMPUTER APPLICATIONS PRACTICAL
S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
Order has Order
been placed? details
1. Desktop Computer System 30 Nos
with latest configuration
2. Power Backup (UPS) 10 KVA
3. Laser Printer 3 Nos
4. Operating System [MS 30
WINDOWS / LINUX] License
5. Office Package [MS OFFICE 30
/ OPEN OFFICE] License

II
GENERAL [COMMON] – COMMUNICATION AND LIFE SKILL PRACTICAL
(B).
S. List of Equipments Quantity Quantity Adequate If Not, If YES, Remarks
No Required Available or Not Whether Purchase
Order has Order
been placed? details
1. An echo-free room 1 No.
2. Furniture / Chairs 30 Nos
3. Public Address System 1 No.
4. A minimum of two 2 Nos
Computers with internet
access, with Audio for
Listening Skill and related
software packages
5. Minimum of Two different 2 Nos
English dailies
6. Minimum of one Tamil daily 1 No.
7. Headphone units – 30 Nos. As
with one control unit with a required
facility to play and record in
Computer
8. Minimum of Three Mikes 3+3 nos
with and without cords
9. Colour TV (min.size – 29”). 1 No.
10. DVD/VCD Player with Home 1 set
Theatre speakers
11. Clip Chart, white/smart 1 each
board
12. Projector. 1 No.
13. Video camera 1 No.
14. Printer, Xerox, scanner m/c 1 each
15. English Weeklies Adequate
/monthlies /journals like
ELTOI
16. Frozen thoughts –monthly Adequate
journal for Life skills by
Mr.Rangarajan

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13. DETAILS OF THE FINANCIAL STATUS OF THE TRUST
S.No Description Amount [ Rs. ]
1. Endowment created with AICTE : YES / NO
2. Current / Savings Account -
Name of the Bank :
Account Number with Amount :
3. Land Value :
4. Building Value :
5. Total Investment on Library Books till date :
6. Total Investment on Equipments till date :
7. Expenditure on Salary :
8. Annual Budget – Recurring :
9. Annual Budget – Non-recurring :
10. Audit Report [Income / Expenditure] :
ENDOWMENT FUND CREATED BY THE TRUST WITH AICTE
Name and Amount Deposited in the bank Date of Instrument No. and date
Place of Bank (Rs. in Lakhs) (name) Maturity

DETAILS OF BANK BALANCE AMOUNT

Type of Whether Account in the Name and Account Balance as Amount
Account name of Trust / College Place of Number On date ( ` in Lakhs)
Bank
Current
Savings

VALUE OF LAND AND BUILDING

Survey Location Extent (sq.m) Built-up Guideline Market Value (`)
Number area (sq.m) Value (`)

14. DOCUMENTS, REGISTERS AND RECORDS

The following Documents, Registers and Records should be maintained / available in the Institution and
it should be produced for verification at the time of inspection to the inspection committee members.
Sl. Name of Register / Record Maintained / Available
No. (YES / NO)
AICTE Web-portal Copy of uploaded application requesting AICTE’s approval for
1.
Institution / Programmes(s)
2. AICTE Letter of Approval Copy for Institution / Programmes(s)
3. Department wise faculty profile

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 4. Department wise Non-Teaching Staff Profile
5. Attendance for teaching and non-teaching staff
6. Advertisement for recruitment of faculty members
7. Minutes of the meeting of Staff Selection Committee
8. Appointment / offer letters issued to faculty members
9. Joining report of staff members
10. Copy of Regulations, curriculum and syllabi (programme wise)
11. Master time table for all courses and all sections with classroom arrangements
12. Academic calendar
13. Accession register for library
14. Stock register for equipment and machinery
15. Stock register for consumable
16. Stock register for furniture
17. Stock register for tools
18. Minutes of the meetings of the Governing council of the college
19. Minutes of the meetings of the Regd. Society / Trust / Company of the college
20. Audited statement of accounts of the college
21. Cash book of the college
22. Acquittance register
23. Fee receipt books (including counterfoils)
24. Funds position / bank certificates / FDR copies to indicate financial stability
25. Composition of the Governing council
26. Composition of the Anti-Ragging Committee
27. Trust Deed
28. Registered Land Documents and Sale Deed
29. Land Use Certificate
30. Land Conversion Certificate
31. Land Classification certificate
32. Village Map
33. Combined field map of lands
34. Encumbrance Certificate for land
35. Patta, Chitta and Adangal for land
36. Field Measurement Book for land
37. Documentary proof for ownership of lands exclusively earmarked for the College
38. DTCP Approved Existing Building Plan
39. Building Sketch [Complete details of Rooms, Labs, W/S, Stores, Library etc.]
40. Legal Opinion
41. Copy of Certificate obtained under sec. 37B of TNLRA 1961
42. Certificates for fire/boiler/electrical safety from competent authorities.
43. Certificate from Health Inspector
Certificate from PWD Supt. Engineer / Panel Engineer approved by respective
44.
District Collector, for the structural stability of all buildings
45. Building and equipment insurance certificate.
LIST OF ENCLOSURES TO BE ENCLOSED ALONG WITH THE APPLICATION FORM
1. Registration Fee [ Rs. 5,000]
2. AICTE Letter of Approval Copy for Institution / Programmes(s)
3. Notarized Undertaking in Rs. 100 stamp paper (Given in next page)
4. Trust Deed Copy
5. Registered Land Documents and Sale Deed Copy
6. Land Use Certificate issued by Revenue Divisional Officer
7. Land Conversion Certificate issued by Revenue Divisional Officer for Wet Land

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 8. Land Classification certificate issued by Revenue Divisional Officer
If Wet Land, Certificate under Section 47 (A) of Tamil Nadu Town and Country
9.
Planning Act, 1971
Certificate under Section 37-B on Tamil Nadu Land Reforms (Fixation of Ceiling
10.
on land) Act 1961 (Tamil Nadu Act 58 of 1961).
Copy of the Form No.38, viz. the application form for permission by Public Trust
under subsection (1) of Section 37-B of the Tamil Nadu Land Reforms (Fixation
of Ceiling on Land) Act 1961 along with the covering letter addressed to
11. (1) Principal Secretary to Government, Revenue Department, Chennai 9;
(2) Commissioner of Land Reforms, Chepauk, Chennai 5 and
(3) Assistant Commissioner (Land Reforms) or equivalent cadre under the
jurisdiction where the Institution is located.
12. Village Map
13. Combined field map of lands
14. Encumbrance Certificate for land
15. Patta, Chitta and Adangal for land
16. Field Measurement Book for land
17. Documentary proof for ownership of lands exclusively earmarked for the College
18. DTCP/CMDA Approved Building Plan
19. Copy of the proceedings issued by DTCP for approval of building plan
Copy of the Challan towards payment of infrastructure and basic amenities
20.
charges to DTCP for approval of building plan
21. Building Sketch [Complete details of Rooms, Labs, W/S, Stores, Library etc.]
22. Legal Opinion
23. Certificates for fire/boiler/electrical safety from competent authorities.
24. Certificate from Health Inspector
Certificate from PWD Supt. Engineer/ Panel Engineer approved by respective
25.
District Collector for the structural stability of all the building
26. Building and equipment insurance certificate.
Copy of Application uploaded in AICTE web portal requesting LOA for 2018-19
27.
(including part 1, part 2 and Application Deficiency Report)

All the New AICTE approved Diploma level Institutions for the year 2018-2019 are requested to submit
the application in the above prescribed format along with the enclosures for affiliation for the year 2018-
2019.
 2 Hard Copies of the application with Hard / Soft bound
 1 Soft copy of Application in word format with Filename as <Institution_name.doc>
 1 soft copy of Application duly signed in pdf format as Filename <Institution_name.pdf>
 The above soft copies should be submitted in a CD
 The above soft copies should also be sent by email to adpdote@gmail.com with Filename as
<College name> . doc.

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 UNDERTAKING

That I have read and understood the contents of the application and the same are true and correct on
the basis of my personal knowledge and on the basis of the records of the institution.

In connection with my / our application for the grant of affiliation of _____________________________

________________________________________________ (Name of the Institution) to conduct ___________
courses with _________ sanctioned intake, and hereby undertake to comply with the following:-

i. That infrastructural, instructional and other facilities are being provided as per the AICTE norms,
standards and guidelines prescribed from time to time.
ii. That the admission to the course will be made only after recognition is granted by the AICTE and
affiliation is granted by the State Board of Technical Education and Training, Tamil Nadu.
iii. That the admission of students, satisfying the eligibility conditions will be made on the basis of marks
obtained in the qualifying examinations or as per the State Government policy in force.
iv. That there shall be reservation of seats for SC/ST/BC/MBC/other categories as per the policy of the State
Government.
v. That the tuition and other fees will be charged at rates prescribed by the competent authority.
vi. That there shall be teaching and non – teaching staff appointed as per the guideline of the AICTE / State
Government. The staff will be paid salary as may be prescribed by the AICTE / State Government from
time to time.
vii. That the management shall discharge the statutory obligations relating to provident fund, pension,
gratuity, etc., in respect of all its employees.
viii. That the management will make adequate funds available for providing satisfactory facilities and for
proper programme implementation announced from time to time.
ix. That the accounts of the institution will be properly maintained and audited annually by the audit
authorities or chartered accountant and will be open for inspection.
x. That the institution will involve all the eligible staff members in the invigilation work, evaluation work and
any other academic assignments prescribed by the Directorate of Technical Education, Chennai from
time to time
xi. In the event of non-compliance by the ___________________________ (Name of the Trust / Society /
Company / College / Institution, etc.,) with regard to the norms and standards of any other conditions laid
down / prescribed by the State Government / State Board of Technical Education and Training, Tamil
Nadu / Directorate of Technical Education, Chennai from time to time, the concerned authorized authority
will be free to take all necessary measures for effecting withdrawal of its affiliation, without consideration
of any other issue and that all liabilities arising out of such a withdrawal would solely be that of the
institution / management.
xii. That the institution shall take all our efforts to eradicate ragging and AICTE / State Government / UGC
rules and regulation on ragging will be strictly enforced.
xiii. That the existing AICTE / State Government / Directorate of Technical Education, Chennai regulations
and the new regulations announced from time to time will be strictly enforced and intimated to the
authorities.
xiv. That we are aware of the fact that monitoring and enforcement of academic discipline in our campus shall
be as required by regulations of State Government / State Board of Technical Education and Training,
Tamil Nadu / Directorate of Technical Education, Chennai.

Principal Chairman / Managing Trustee / Secretary / any other

authorized signatory
Name: Name:

Note : A notarized undertaking in Rs.100 stamp paper duly signed by the Principal and the authorized
signatory of the trust is to be enclosed

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 Endorsement of the Principal

I, Thiru. / Tmt. ___________________________ son / daughter of

Thiru. _____________________ on behalf of the (college name)
___________________________ hereby declare that the particulars furnished in the
application are correct to the best of my knowledge.

Principal
(Name in Capital Letters)

Seal
Place:
Date:

Declaration by the Management

I, Thiru. / Tmt. ___________________________ son / daughter of

Thiru. _______________ on behalf of the trust, viz., ___________________________
hereby declare that the particulars furnished in the application are correct to the best of my
knowledge. No programme(s) will be started without the prior approval of the AICTE and the
grant of affiliation by the State Board of Technical Education and Training, Tamil Nadu for the
academic year concerned and all the original documents related to the particulars given in
the application will be produced at the time of inspection and whenever called for.

Chairman / Secretary
(Name in Capital Letters)

Seal
Place:
Date:

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