PART-A

1. DETAILS ABOUT INSTITUTE

a. Name & address of the society/Trust : NAME OF THE TRUST

Address
Name & address of Secretary/ : Sri.
Correspondent of society/trust Address

Phone Nos. & Cell No’s. Mobile:

b. Name & address of the Secretary/ : Sri.

c. Correspondent of Society along with E-mail:
Telephone No. /Fax No and STD code Mobile:

d. Name & address of the Institute along :

With Telephone no. /Fax no and STD
Code & cell No of the Principal, email id
[if different from ’a’ above]
Principal: ; Mobile:
Type of Institute (Govt./ Govt. Aided /Private) : Private
e. Minority YES/ No

f. Year of establishment of the Institute with proof: Year

200x.
Trust resolution is enclosed. (ANNEXURE-I)

DETAILS OF APPROVED AND NOT-APPROVED EXISTING COURSE (S) / PROGRAMME (S) CONDUCTED BY THE
INSITUTION

1. Approved by,

2.

PROPOSED Courses : B.Sc. DEGREE names.

g. AICTE/Govt. Sanction details: NA

Sanctioned
S.No. Course AICTE/Govt Date of approval Intake as per Year of
Approval No. approval introduction

h. Present position NA
NBA Accreditation Period NBA Accreditation
(Y/N)

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i. Location of land in which the Institute is situated :

Whether the Institute is sharing facilities : YES/NO

With any other institution/any other
Programmes ( if yes give details)

1. Whether the civil amenities are available : We do not share any of the facility with any
other institution, though all are available.
2. Electricity
3. Sewerage
4. Water
5. Transport
6. Road Available

2. ACADEMIC PREFORMANCE OF THE INSTITUTE :

NOTE: Present courses
a. (Results of final year students of the last two years)

No.of students No. of students Students passed in the

S.No. Course Admitted in the first Appeared in the final final year examination
Year. examination

b. Placement activates (Last year)

i. Whether placement Cell has been established : YES

ii. Number of Students passéd :

iii. Number of Students placed through institute :

3. DETAILS ABOUT GOVERNING BODY

a. Name and address of the Governing Body members : 1

2.
3.
4.
5.
6. Principal’s name - Member & Secretary

b. Number of Governing Body meeting held during past :

Three years with date ( Minutes of Governing Body
Meeting to be examined by visiting committee at the time of visit)

c. Details of the last Governing Body meeting held:

Minutes of the meeting enclosed. (ANNEXURE-II)

4. LIST & STATUS OF HIGH COURT CASES PENDING AGAINST THE INSTITUTE : N A

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S.No W.P.No. Filed by Respondent subject Interim Action Status
. Orders Taken by

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 PART- B

DETAILS ABOUT THE EXISTING INFRASTRUCTURE FACILITIES AVAILABLE WITH THE

INSTITUTE:

1. LAND DETAILS
PL REFER ANNEXURE –III
a.
S.No. Program Land in Acres Registration Registration Survey Village Mandal
(earmarked Number Date No.
exclusively
for the
program)

b. Whether the above survey number of

land are Contiguous or not? : NO
c. If the land is leased in the name of the
Institution/Trust/Society (years) : YES

2. BUILDING PARTICULARS (Diploma)

a. Does the Institute have permanent building? : YES
b. If yes, is it located in the land in ‘1’ above? : YES

3. ACADEMIC AREA

a. Summary of Academic Area

Furnished by Given by Adequate Proposed for
College Inspection Furniture/ construction
Sl.No. Particulars Area
No.of Total No.of Total No.of Total
room Area room Area room Area
s (sq.m) s (sq.m) s (sq.m)
Sq. M 20 Nos. in
a Class rooms Sq. M each Class
Room

b Tutorials and Sq. M 20 Nos.

drawing halls Sq. M

c Seminar halls Sq. M Sq. M 30 Nos. NA NA

d Computer lab Sq. M 20 Nos. NA NA
Sq. M
e Work shops Sq. M Sq. M Nos. NA NA
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 Sq. M Sq. M Nos.

f Library Sq. M Nos. NA NA

(stacking Sq. M
arrangement)
g Library Table Nos. NA NA
(reading s& Sq. M Sq. M
arrangement) Chair
s
h Dispensary / Sick Room Sq. ft. Additional details if any

b. Whether the following particulars are adequately furnished:

Sl.No. Particulars Reason if any

a. Class Rooms Yes NA
b. Tutorials Yes NA
c. Drawing Hall Yes NA
d. Seminar Hall Yes NA
c. ADMINSTRATION AREA

Sl. No. Particulars No. of rooms available Total available

01 Open Office System Nos. Nos.
d. RESIDENTIAL AREA (Students) : Make their own arrangements with private boarding
and lodging providers. Facilities available there in are as follows

Sl. No. particulars No. of Rooms available Total available

01. Adequate Amenities 02 Nos. Major Halls
for xxx Students at a capacity – xx Nos. xxx Nos.
time with attached
Kitchen
e. AMENITIES
Sl. No. particulars No. of Rooms available Total available
01. Adequate Amenities Bathrooms & Toilets
for xxx students at a xx Nos. xx Nos.
time

f. PROPOSED TO CONSTRUCT THE ADMINISTRATIVE AMENITIES

Sl. No. particulars No. of Rooms available Total available

01. Canteen Complex Kitchen & Dinning hall
under construction in for students and xxx Nos.
Institute Campus separate space for
staff/ VIP

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 4. WORKSHOP FACILITIES

Infrastructure to be verified depending upon the requirement of the programme(s)

applied by Trust /Society and the syllabus followed:
PL REFER ANNEXURE –B.

a. DETAILS OF VARIOUS LABS /WORKSHOPS/COMPUTER LAB CREATED:

Proposals
S.No. Course Name of Area Details of Facilities of for increase
the lab (Sq.m) equipments Lab in facilities

5. LIBRARY FACILITY

The same to be verified depending upon the requirement of programme(s) applied by

the Trust/Society and syllabus followed.
PL REFER ANNEXURE – V, VA
Details of Library Books

S.No. No. of Titles No. of No. of Journals Total Total Verified

available Volumes available Investment Investment Yes /No
Available for for
purchase purchase
last year till date (In
(in Rs.) Rs.)

a. Reading room facility : Tables : 05 Nos.

: Chairs : 20 Nos.
b. If the purchase vouchers for the books
Procured available or not (to be verified by
The expert committee) : BOOKS ARE DONATED BY THE TRUST

6. FACULTY (TEACHING) COURSE WISE

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 a. No. of faculty at present : Pl refer ANNEXURE - VI
No. of faculty proposed to be recruited : On requirement basis
No. of supporting staff at present : xxx
No. of supporting staff to be recruited : xxx

b. 1. Faculty & Staff Details : Pl refer ANNEXURE – VI

2. Scale of Pay : Pl refer ANNEXURE – VII
3. Gross Salary & Service: Pl refer ANNEXURE – VIII
(MONTHLY PAY SLIP DETAILS)

S. No. Name Designatio Qualification Scal Gross Length Length Acquaintance

of the n of the e of salar of of Register
staff staff pay y service service verification
(YY) months (Y/N)
(MM)

c. Method of faculty selection : By the selection Board headed by Chairman

d. Whether the faculty selected is approved : NA
From the state Govt. AICTE (Attach proof)

e. Whether AICTE pay scales are implemented: NA

To the teaching staff (Attach Proof)
f. Whether PF Scheme /other retiring : NA
Benefit Scheme is implemented (Attach Proof)
g. Whether Tax is being deducted at source : YES
Towards income Tax (Attach Proof) : Pl attach ay details as Annexure as IX

h. Staff student ratio : 1:20 ( Class room instruction)

1:20 (Workshop practical)
i. Total number of Non-Teaching staff : xx Nos.

7. INCOME
in Lakhs
a. Source of Income of last year Audited Accounts
Source of Income: For the year
ending 31st March
2014 or 2015
Central Government NIL
State AICTE NIL
Government other Central/ State NIL
NIL
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 Govt. Bodies

Private Trust/ Companies (Grant) xx

Donation xx
Students Fee xx
Internal Revenue General xx
Other Bank Interest, Hostel xx
b. Expenditure during last year
Particulars
Salary of Faculty xx
Salary of Non-Teaching Staff xx
Administrative Ministerial xx
Library xx
Computer centre xx
Labs and workshops xx
Other Bank Interest, Hostel, Rent, xx
Receipts etc.,

c. Whether the accounts are audited : Enclosed

(Enclose audited income & expenditure Pl refer ANNEXURE – X-A; X-B;
Attachment and balance sheet for last three years)
d. Whether endowment funds/FDR created
(if yes amount in Rs. Lakhs) : NO

FDR No. Name of join FDRs Name of the Bank Maturity date

All the information furnished above is true to best of my knowledge.

Signature of Secretary/
Correspondent of Society /Trust with seal