Application Letter for the establishment of Commerce and Management Study Centre of
Yashwantrao Chavan Maharashtra Open University, Nashik
This Application should be forwarded through
District/Regional Centre Only
Date:
Place:
To
The Director,
School of Commerce & Management,
Yashwantrao Chavan Maharashtra Open University,
Nashik- 422 222.
Subject : Application for the establishment of a Study Centre of Yashwantrao Chavan
Maharashtra Open University for Certificate in Fire and Safety Engineering
Management (C 97) Programme.
Sir,
This College/Institution is keenly interested in establishing a Commerce and Management
Study Centre of Yashwantrao Chavan Maharashtra Open University for Certificate in Fire
and Safety Engineering Management (C 97) Programme.
I am sending herewith the detailed information of our College / Institution in the prescribed
format.
I am also enclosing a crossed Demand Draft of a nationalized bank of Rs.5, 000/- towards
Non refundable Processing Fees drawn in favour of Finance Officer, Yashwantrao Chavan
Maharashtra Open University, Nashik, payable at Nashik and a memorandum of
understanding duly signed by concerned authorities of our institute/college.
I request the University authorities to consider our application sympathetically and grant us a
Study Centre for Certificate in Fire and Safety Engineering Management (C 97)
Programme.
Thanking you and hope for early favourable reply.
Yours sincerely
(Principal/Chairman/ Secretary/Head of the Institution)
Forwarded through - Regional District /Regional Centre:…………………………..
Enclosed: 1. Information Report, Application Form & MOU
2. D.D. No.:……………………. Rs.5, 000/Date:………………………… Bank Name:…………..
Page 1 of 26
YASHWANTRAO CHAVAN MAHARASHTRA OPEN UNIVERSITY
Dnyangangotri, Near Gangapur Dam, Nashik 422 222
Application Form 2015-16
School of Commerce and Management Study Centre
-----------------------------------------------------------------------------------------Regional Centre:______________________
District Centre:_______________________
Programme: Certificate in Fire and Safety Engineering Management (C 97)
Programme Code: C 97
Non Refundable Processing Fees: Rs 5,000/D.D. No.:……………………. Rs.5, 000/-
Date:………………………… Bank Name:…………..
1. Date of Application Received at District Centre:
Application to be Accepted / Rejected
If Rejected: Reason:
Signature of District Centre Head/Co-ordinator:
2. Date of Application Received on Regional Centre:
Application to be Accepted / Rejected
If Rejected: Reason:
Signature of Regional Centre Head/Co-ordinator:
3. Date of Application Received at Head Quarters Nashik
Application to be Accepted / Rejected
If Rejected: Reason:
Signature of Director School of Commerce and Management /
Programme Co-ordinator:
Page 2 of 26
CHECK LIST: Please Tick ( √) if submitted
Sr.No
Particulars
1
Demand DraftAmount : Rs 5,000/Validity:_________
2
Educational Campus
Affiliated to University
Bachelors Degree
programme Offered
Application Form
Appendix-I
Reading Material in
Library
Appendix-II Head/
Counsellors’/ Coordinators
Bio data
Attached
Appendix-III
Resolution as per
format on Letter Head
Appendix-IV
3
4
5
6
7
8
Applicant
District/
Regional
Centre
Head
Quarters
Inspection
Committee
MOU on Rs. 100 NonJudicial Bond Paper
9
True
of
Layout,
copies
rent
of
etc
mentioned in the form
Sign:
Date:
Name:
Page 3 of 26
Instructions for filling up the form:
1.
2.
3.
Use capital Letters only.
Do not overwrite.
Enclose relevant document in the sequence mentioned.
IMPORTANT NOTE:
1. Recognition will be given for Three years only and for renewal study centres need to apply in
prescribe format by paying requisite fee as per the university rules.
2. Applications sent directly to the School/HQ, will not be considered for approval.
MINIMUM REQUIEREMENTS FOR ESTABLISHMENT OF NEW STUDY
CENTRE
Applicant fulfilling the following criteria will be eligible for the recognition to start
programs in Fire and Safety Programme
1. Applicant/ Applicant body must possess qualification in Fire and Safety Field with
minimum of 5 years Practical Field Experience in Active Fire and Safety Services.
2. Possess qualification in Fire and Safety Field with minimum of 5 years Teaching and
Training Experience in Fire and Safety Field in recognized Institution.
3. Applicant has to apply in prescribed format with application and Detailed Project
Report along with the Presentation.
4. Applicant has to fulfill the necessary Approval/ Processing Fees decided by the
university in Demand Draft only which is non refundable.
5. Applicant/ Trust/ Institution must have separate Fixed Deposits in the name of
Institution/trust which will run the new study centre in Nationalized Banks for the
development of the Study Centre (Minimum amount of 5 lacs.). The amount of
deposits is according to the status of the program proposed to be started.
6. Applicant must have satisfactory/enough infrastructure to run the schedule program
efficiently. Like Availability of minimum land required for Field Training purpose like – P.T.
and Parade / Fire Drills and Other related Demonstration and Assembly.
 Availability of – Minimum 6 classrooms, Administrative office, Library,
Reading room, Computer room, Internet facility, Equipment room, Store room
 Availability of adequate Co-ordinator and Teaching Faculty and other staff
 Availability Hostel facility, Mess facility, Medical Ads according to the
requirement for starting a new academic program.
 Availability of conveyance facility in emergency and in general for students
and parents
7. Applicant must possess his own Practical Equipment according to the program
curriculum, which are sufficient for field training, demonstrations and applications.
8. Applicant must have tie up with corporation Fire and Emergency Services, Local
Bodies, Emergency Medical Services for practical field training and demonstrations
necessary for trainee students during their academic year.
9. Applicant must possess list of different nature of industries and disciplinary coordination for industrial visit, project work, and practical attachments necessary for
the trainee students during their academic year.
10. Applicant must have different types of books, journals, magazines, periodicals
according to the academic programs rather than the books provided by the university.
Page 4 of 26
11. Applicant must follow all rules and regulation for admission procedures, registration
procedures, regular training and teaching schedule, examination and evaluation
procedures and co ordination/ communication procedures with university and
students.
12. Applicant must up date / keep all documentary records of students attendance, staff
attendance, assignments, internal examinations, internal marks, external marks, final
result, repeaters (Journal submission, assignment submission, project submission,
internal practical/ project marks, industrial visit marks etc.) and be produced or keep
available in front of university committee when required or time to time.
13. Applicant must maintain economic records related to academics and new
developments of running financial year and produced in front of university if
required.
14. Centre In-charge will be a regular/ permanent employee preferably the head of the
existing institute or college.
15. Administrative Staff ( one each)
a. Programme Co-ordinator: Full Time faculty member of the existing institute or
college possessing Post Graduate Degree.
b. Assistant
c. Peon.
Page 5 of 26
Information of the College/ Institute Applying for Study Centre
Please Note: All fields mentioned under are mandatory.
1
A:
General Information about the Applicant
Name of the College/
Institute
Address
2
City/Town
3
Tahsil/ Taluka
4
District
5
State
6
PIN Code
7
Telephone with STD
Code Office:
8
FAX Details
9
Email Address
10
Affiliated to
University/Board
11
Approval Number and
Date of Approved
University
12
a. Approval Number
b Date:
Type of Affiliation
Temporary / Permanent
13
Expiry Date of
Affiliation (if any)
14
Page 6 of 26
Type of
College/Institute :
15 Private / Government
Timing of the
College/Institute
16
The College/ Institute
has: (Please give
17 details)
a. Schools
(Primary/ Secondary)
b. Jr. College
(Arts/Com/Sci/Voc etc)
c. Sr. College
(Arts/Com/Sci/Voc etc)
d. Any Other
Is your college /Institute
already a Study Centre
of YCMOU for any
18 other Programme?
a. If Yes Study Centre
Code
b. If Yes Please
specify programmes
Number of teaching
staff (fulfilling
YCMOU criteria)
19
Number of non-teaching
20 staff
Name and distance of
the nearest active
YCMOU Fire and Safety
Engineering Management
21
Study Centre (in km)
Page 7 of 26
B: Information about Parent Organization of the Applicant
Name of the Parent
1 Organization
2 Address
3
City/Town
4 Tahsil/Taluka
5
District
6
PIN Code
Telephone with STD Code
7 Office
8 FAX Details
C: Constitution of Parent Organization
Legal status of Organization (Public Trust Act 1950/ Societies Registration Act 1860/
Government Body)
1 Status:
Registered Under: (Give name of the
2 governing authority)
3 Registration No:
4 Date of Registration:
5
Name of the Chairman
6 Address of the Chairman
7 Contact Number of the Chairman
a Office Phone No. With STD Code:
Residence Phone No. With STD
b Code:
10
Mobile No:
Page 8 of 26
D:Information of the Centre Head( Principal of the existing College/
Institute)
Affix passport
size latest
photograph
1 Name
2
Residential Address
Phone with STD Code
3 Office:
4 Residence:
5
Mobile No
6 E-Mail Address
7
Date of Birth
Date of joining the Present
College/ Institute
8
Educational Qualification
(Enclose necessary true
9 copies of certificates)
Experience (Enclose
necessary true copies of
10 certificates)
Teaching (years)
Professional( years)
Total( years)
Page 9 of 26
E: Information of the Coordinator
Affix passport
size latest
photograph
Name of the person who will work
1 as coordinator
Residential Address
2
Office Phone No. with STD Code:
3
Residence Phone No. with STD
Code:
4
Mobile No
5
E-Mail Address
6
Date of Birth
7
Date of joining the College
8
Educational Qualification (Enclose
necessary true copies of certificates)
9
Experience (Enclose necessary true
copies of certificates)
10
Teaching (years)
Professional( years)
Total (years)
Page 10 of 26
F: INFRASTRUCTURAL FACILITIES
Please Give the details and enclose the true copies of the layout of the space
in the college, which will be utilized as the Study Centre purpose with
dimensions. Also enclose Ownership/lease/rent documents.
Lecture Halls/ Rooms Available of Counselling Sessions
Name of the building in
1 the campus
Number of Rooms in
2 the Building
Number of Rooms
available for YCMOU
Counselling Sessions in
3 the Building
F-1: Details of Lecture Halls/ Rooms available for YCMOU Counselling Sessions in the Building
Sr.
No
Existing
Name/
Number
of the
Lecture
Halls/
Rooms
Student Capacity
For
Dimensions
Area
in sq.
ft
No in each Classroom
Tables
Classes
Chairs
Benches
Board
Fans
Tube
lights
Exam
1
2
3
4
5
6
7
8
9
10
Page 11 of 26
Windows
F: 2Details of Computers available for YCMOU Counselling Sessions/ practical’s in the
Building
Total Number of Computer -:
Sr.
No.
Machine Type
Desktop /
Laptop
RAM
Hard Disk
Capacity
Monitor
Type
CD /
DVD
Drive
Version of
Operating Number of
System
Computers
1
2
3
4
5
F:3: Computer Lab available for YCMOU Counselling Sessions/ practical’s in the Building
Sr.
No
Existing
Name/
Number
Lab
Dimensions
Area
in sq.
ft
Student Capacity
For
Classes
Exam
No in each Lab
Tables
Chairs
Benches
Board
Fans
Tube
lights
1
2
3
4
5
Page 12 of 26
Windows
G: Library Details
N
o
Particulars
Dimensions
Area
in
sq.
ft.
No. Of
Tables
No.
Of
Chairs
No.
Of
Racks
Boards
No.
of
fans
No. of
Tube
lights
Library
1
Reading
Room
2
G: Other Library Details
Sr.No Particulars
Details
1 Seating Capacity
2 No of Books available (Titles)
No of Books available (Total
3 Copies)
4 No of Journals
5 No. of News paper
H: Teaching Aids Available
Sr.No Particulars
Yes/ No
Television/ DVD Player
1
LCD Projector
2
Slide/ OHP/ Projector
3
Recorder
4
Quantity
Page 13 of 26
No. of
windows
I: Other Facilities in the same Building where Counselling Sessions are
proposed
Sr.
Details(eg
Area in
No Particulars
Yes/ No
Room No) Dimension Sq.mt
Reception Room
1
Staff Room
2
Stores
3
Drinking water
4
First Aid
5
Ladies Room
6
Ladies Toilet
7
Gents Toilet
8
Other
9
Page 14 of 26
G: Separate Office for YCMOU Centre
Sr.No Particulars
Details
Existing Room No
1
Dimension
2
Area in Sq mt
3
No of Tables
4
No. of Chair
5
No. of Cupboards
6
No. of Racks
7
White/ Black Board
8
Notice Boards( 1-Office and 1 -Lobby )
9
No. of Tube lights
10
No. of Fans
11
No. of Windows
12
Page 15 of 26
H:Counsellors Details: Please note 50 per Cent of the counsellors should be existing regular
teaching staff of the college/ Institute
(Enclose the Faculty Bio-data of each Counsellor in prescribed format given in Appendix I along
with the true copies of the mark sheets and certificates)
Sr.
No
Name of
counsellor
Subject
Regular/
Visiting
Staff
Approved
by
Convention
al
University
(Yes/ No)
Experience (in Years)
Approval
No. &
Date
Educational
Qualification
Teaching
Professional
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Page 16 of 26
Total
I:Non Teaching Staff Details:
Sr.
No Name
Designation Age
Regular/
Educational Temporary
Qualification Staff
Experience ( in
Years)
1
2
3
4
5
6
7
8
9
10
Page 17 of 26
UNDERTAKING
The Principal/ head is willing to co-operate for the following functions to be
performed by him and the staff working under him for effective functioning of
the proposed study centre:
a. Participate and supervise work of the study centre.
b. Make teaching staff available for counselling.
c. Make teaching and non teaching staff available for Co-ordinating the
programme.
d. Make teaching and non teaching staff available for exam related work.
e. Make available Non- Teaching staff to work part –time for the study
centre.
f. Library facility will be made available on Saturday, Sunday and
whenever counselling sessions are scheduled.
g. Computer lab facility will be made available on Saturday, Sunday and
whenever counselling sessions are scheduled.
h. Drinking water, first aid etc. and other necessary amenities will be
made available on Saturday, Sunday and whenever counselling
sessions are scheduled.
The information filled in the Application Form is true to the best of our
knowledge.
The Principal/Head and the College/ Institute Authorities do hereby undertake
to give all necessary co-operations for efficient and effective functioning of the
Study Centre of the Yashwantrao Chavan Maharashtra Open University, if
granted to our College/ Institute
Date:
Seal of the College /Institute
Name and Signature of
Principal/ Head
Place:
Name and Signature of
Chairman of the Organization
Page 18 of 26
APPENDIX: I
READING MATERIAL AVAILABLE IN LIBRARY
1. BOOKS: Please Note Minimum 500 books and 25 Titles per course/ subject should
be available for reference (Commerce & Management subjects).
Sr.
No.
ACCESSION SUBJECT
No.
TITLE
PUBLISHER YEAR
OF THE
OF
BOOK
PUBLI
CATIO
N
NAME
OF
AUTH
OR
Marathi/
English
2. LIST OF MAGAZINES AND JOURNALS
Please mention latest available
Sr.
No.
ACCESSION Name
No.
National/ Frequency
Internatio
nal
PUBLI
SHER
YEAR
/
Month
OF
PUBLI
CATI
ON
Marathi/
English
3. List of Newspapers :
Sr.
No.
Name
National/
Local
Frequency
Marathi/
English/
Hindi
4. Online subscriptions if any mention all the details.
5. CDs’/ DVDs’ available mention all the details
Page 19 of 26
APPENDIX: II
YASHWANTRAO CHAVAN MAHARASHTRA OPEN UNIVERSITY, NASHIK
SCHOOL OF COMMERCE AND MANAGEMENT
BIODATA FORMAT OF HEAD/COUNSELLORS’/CO-ORDINATOR
(PLEASE
ATTACH
THE TRUE COPIES OF THE MARK SHEETS AND CERTIFICATES)
(PLEASE USE CAPITAL LETTERS ONLY)
1. NAME:_____________________________________________________
2. DESIGNATION:________________________________________________
Affix passport
3. COLLEGE/INSTITUTE:____________________________________________
size latest
photograph
4. ADDRESS FOR COMMUNICATION: __________________________________
___________________________________________________________
5. MOBILE NO: ___________________ LANDLINE NO :__________________
6. EMAIL ID: ______________________________________________
7. DATE OF BIRTH: ___________
(DD/MM/YY)
AGE: __________ YEARS
8. EDUCATIONAL QUALIFICATION:
DEGREE
SUBJECT
YEAR
MARKS
OF
OBTAINED
PASSING (PERCENTAGE)
CLASS
SSC
HSC
UG
PG
M.PHIL
PHD
NET/SET
OTHERS
9. M.PHIL/ PH.D RESEARCH TITLE:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Page 20 of 26
10. EXPERIENCE IN YEARS:
TEACHING
INDUSTRIAL
RESEARCH EXPERIENCE:
TOTAL
___________________ YEARS
11. TEACHING/PROFESSIONAL/WORK EXPERIENCE
NO. NAME OF THE
POSITION
NATURE OF
INSTITUTION
HELD
WORK
PERIOD OF
EXPERIENCE
FROM
TO
12. RESEARCH GUIDANCE
A) M. PHIL. STUDENTS - DEGREE AWARDED : ____________
B) PH.D. STUDENTS - DEGREE AWARDED : ____________
13. NO .OF RESEARCH PUBLICATIONS IN JOURNALS / PERIODICALS /
CONFERENCE PROCEEDINGS:_____
25. SUBJECTS WHERE YOU CAN CONTRIBUTE AS AN EXPERT FOR COUNSELLING/
PAPER SETTING/CHECKING/ :
1._________________________________________________
2._________________________________________________
3._________________________________________________
4._________________________________________________
5._________________________________________________
I HEREBY DECLARE THE INFORMATION MENTIONED ABOVE IS TRUE TO THE BEST OF
MY KNOWLEDGE
DATE:
SIGNATURE:
PLACE:
Page 21 of 26
APPENDIX-III
RESOLUTION OF THE SOCIETY (To be submitted duly filled on the letterhead of the
Institution)
It is resolved unanimously in the meeting of the Governing body of…………………………..
…………………..………………………………………………. held on …………………….
under the Chairmanship of Shri ………………………………………………………………..
that the Certificate in Fire and Safety Engineering Management (C 97)
Programme Study Centre of Yashwantrao Chavan Maharashtra Open University, Nashik be
established in …………………………………………………… College /Institute
/Foundation /Trust.
If the University permits the College /Institute/Foundation/Trust to establish the centre, we
undertake to provide all the necessary academic and infrastructural facilities and co-operate
for the smooth and efficient functioning of the Study Centre. We shall extend full cooperation
and support for the smooth conduct of these academic programmes (including end exam and
central assessment programme), as per the approved rules of the university. We shall abide by
the rules and regulations of the Yashwantrao Chavan Maharashtra Open University, Nashik
prescribed and revised from time to time.
If the study centre is closed down for any reason, equipments, furniture, books supplied by
the University shall be returned to the University through the…………………………………
Regional Centre.
We shall have no objection if the University ceases the services of Counsellors, Co-ordinator
and Office Staff appointed at the Study Centre.
Proposed by………………….
Seconded by………………….
Place:
(Seal of
Signature
Date:
the Institution) (Name:
Secretary
Institution/Foundation/Trust
Signature
)
(Name:
)
Chairman
Institution/Foundation/Trust
Page 22 of 26
Appendix-IV
Memorandum of Undertaking (MOU) for YCMOU Study Centre, Nashik
(To be submitted by the Management on Rs. 100 Non-Judicial Bond Paper)
We,
Mr./Mrs/Ms._____________________________________________________________
Chairman of (Organization Name) ___________________________________________
Mr. / Mrs /Ms____________________________________________________________
Secretary of (Organization Name)___________________________________________
Mr. / Mrs./Ms____________________________________________________________
Principal/Director of the (College/Institution Name)______________________________
Have been given to understand about the various Academic Programs under the School of
Commerce and Management, Yashwantrao Chavan Maharashtra Open University ( herein
after referred to as YCMOU), Nashik.
We hereby agree to offer the services of our organization for the establishment of Study
Centre of YCMOU for Certificate in Fire and Safety Engineering Management (C 97)
programme under the School of Commerce and Management, YCMOU, Nashik.
1. We hereby agree to spare the accommodation, computing facilities, equipments, tools
and other infrastructure facilities for implementation of the programme as prescribed
by YCMOU from time to time.
2. We hereby agree to ensure security and record of learning material provided by
YCMOU with necessary documents.
3. We hereby agree to provide a separate and easily accessible office space for YCMOU
Study Centre. Moreover, we agree to put up sign board bearing the Name of
YCMOU Study Centre at the prominent location.
Page 23 of 26
4. We hereby agree to provide willing faculty members of our institute to work as
designated Study Centre Head, Co-ordinator, Teacher Counsellors, Accountants and
Assistant as prescribed by the YCMOU from time to time.
5. We hereby agree to make available the necessary training materials, consumables,
electricity and water facilities to the students undergoing training programs of the
university without demanding any financial compensation from the university.
6. We hereby agree to maintain record of Financial Accounts, Receipts & Expenditure
as prescribed by YCMOU from time to time and funds received on account of
admission/block grants shall be used for centre Operation and Development only. We
understand that the study centre share of programme fees includes expenditure
towards running of study centre which includes components like salaries of staff,
honorarium to counsellors, honorarium given to supervisors for theory examination,
examiners for practical examinations, assessors of assignments, payment towards
advertisements TA/DA for travel to attend various events organized by the university,
cost of computing and other facilities at the study centre etc. Hence, we will not
demand any financial compensation from YCMOU for such kind of expenditure.
7. We hereby agree to maintain all records in respect of the programmes and submit the
same to the university authorities as and when asked for.
8. We hereby agree to pay honorarium through crossed cheque to Centre Head, Coordinator, Accountant, Assistant, Peon and Teacher Counsellor as prescribed by the
YCMOU from time to time.
9. We hereby agree to implement the programs of the YCMOU with due dignity, quality
and sincerity and maintain the high standard of education values as prescribed by the
YCMOU from time to time.
10. We hereby agree to follow procedures regarding programme promotion, admission,
examination and other procedures specified by YCMOU.
11. We hereby agree to take every care to scrutinize Admission Forms of students and
verify eligibility of students to various programmes.
Page 24 of 26
12. We hereby agree to collect the study centre fee from students as prescribed by
YCMOU and issue the receipt of payment to the respective student. In any case we
will NOT charge fees more than what YCMOU has prescribed.
13. We hereby agree to submit student admission forms to YCMOU and collect study
material from YCMOU or as prescribed by YCMOU and distribute to the students
without demanding any financial compensation.
14. We hereby agree to inform to the students all instructions received from the
University regarding the course, contact of sessions, conduct of examination etc.
15. We hereby agree to extend full cooperation and support for the smooth conduct of
these academic programmes (including end exam) as per the approved rules of the
university.
16. We hereby agree to send our counsellors and experts for paper setting, question bank
development and other activities carried by YCMOU.
17. We hereby agree that the examination of our students may not necessarily be
conducted at our study centre.
18. We hereby agree to provide computing and other facilities for conduct of examination
in case YCMOU decides to organize examination of our students or students of other
study centres at our study centre.
19. We hereby agree that Recognition will be given for three years only and for
renewal we need to apply in prescribe format by paying requisite fee as per the
YCMOU rules
20. We hereby agree that YCMOU shall have full power to close down our Study Centre
in consistent with YCMOU rules, regulations, policies and powers without assigning
any reason and without any reimbursement for loss from YCMOU to our
organization.
Page 25 of 26
21. We hereby agree that all legal disputes regarding study centre and enrolled students
shall be subject to Nashik jurisdiction only
22. We hereby agree that any dispute with regards to the opening or closing of study
centre shall be sorted out with the mutual discussion and the Director of the
Concerned School/Division of YCMOU Nashik shall be the final authority to pass an
order to that respect which shall be binding on the institute running the YCMOU
study centre.
23. We have read all the Rules and Regulations given by the authority of YCMOU and
we hereby agree to abide by the Rules and Regulations to that effect. Failing of which
our study centre shall be closed.
1) Chairman of the Organization
Name and Signature
2) Secretary of the Organization
Name and Signature
3) Principal/Director of the College/ Institution
Name and Signature
Date:
Place:
MOU Accepted/Rejected/
Signed
& Send Back for Record
Director
School of Commerce & Management,
YCMOU
Date:
Place:
Page 26 of 26