Mnc Form Proposal1
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Application No
Application for proposal to start RANM/B.Sc./P.C. B.Sc./M. Sc. / specialty Nursing programme for Academic Year 2010-11 1. Name and Address of the Trust Society
________________________________ ________________________________ ________________________________ ________________________________
2. Name and Address of Chairperson:
________________________________ ________________________________ ________________________________ ________________________________ _________________ ________________________________
Telephone No. With STD Code E-mail 3. Name and Address of the prop. Institute:
4. Proposal Submitted for: (Tick Appropriate)
________________________________ ________________________________ ________________________________ ________________________________ New institute Increase seats
Page 1 of 1
New Course Closing of institute
INDEX
Sr. No.
Contents
1
Section-I Information about Society /Trust and the Institute.
2
Section-II; Information about the proposal for the Academic year 2010- -2011.
3
Section- III: Infrastructural facilities available.
4
Section-IV: Declaration to be given by the Chairperson and Secretary of the Society/Trust
5
Any Proofs/Documents attached to the proposal
Page No.
APPENDIX – A:-Instruction for submission of proposals:
6 APPENDIX-B: Terms and conditions for the proposals.
7
Note: Please don’t take print of this form and don’t fill it by hand. Use the word file and type all information in the form on Trust Letter head on the computer and then take a print.
Page 2 of 2
SECTION -1 A. Information about Society/Trust and the Institute 1. Name and Address of the Society/ Trust Name
Address:
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Pin Code Tel. No with STD Code Fax No E-mail address: 2. Registration No. & Date of the Society/Trust: ----------------------------------------------------With Charity Commissioner (Attach copy of Registration Certificate) 3. Name of the present chairperson and Secretary of the society / Trust along with tenure Chairperson : __________________________________________________ Secretary : __________________________________________________ Duration of Tenure:-from ______________________to______________________ Name of Trustees and Addresses (enclosed trust deed) Sr. No. 1 2 3 4 5 6 7
Name of Trustee
Address of Trustee
4. Name and Address of the proposed new or existing Institute Name: Address:
Pin code Phone No with STD Code Fax No E-mail address
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 3 of 3
5. Whether the above institute is already sanctioned or permitted for any course by any body Yes / No. --------If yes, then give below (i)Approval letter no. & Date: _______________________________________________ (ii)Approval letter no. & Date: ________________________________________ 6. Whether the Society/Trust runs any other educational Institutions/Courses? If yes, give the information in following table.
Sr. No.
Name of the Institutions & Addresses
Name & Entry Level of the Courses
Whether Recognized by the Government or Any other Body
Whether Aided by Central / State or Whether unaided
7. Course(s) with intake capacity and other details in the following table in respect of the existing (Government /council) Institute.
Title of Name of Sr. the Affiliating No. Course Body
Diploma/ Degree/ Certificate/ PD/ PGD/ AD
Yearly/ Semester
Duration
Sanctioned Intake
Year of Approval
Entry Level Qualification
(i) Fee charged for existing courses
Sr.No.
Name of the course
Tuition Fee
Page 4 of 4
Other fee
Total
SECTION-II
Information about the proposal for the academic year: 2010- 2011 Proposal is submitted for (Tick Mark whichever is applicable) (i) Permission of New Institution OR (ii) Introduction, of new course/s and or variation in intake in the existing Recognized Institute OR (iii) Closure of Institute.
Read before filling following table. 1) The courses recognized by MAHARASHTRA NURSING COUNCIL, Mumbai are available on website. (www.maharashtranursingcouncil.org) 1. (i) Proposal for Recognition of New Institute Level of the course i.e. Degree, Diploma. Entry Duration Name of UG, Sr. Course Title level Of the Affiliating PG, No (In full form) Qualificat Course Body specialty ion Nursing Diploma Certificate etc.
Intake Capacity
NOC From state Govt.
Total a) Whether the syllabus is existing for the proposed courses in –_______________________ 1) Maharashtra Nursing Council, Mumbai
YES / NO
b) Whether NOC is given by the concerned 2) Indian Nursing Council, New Delhi –
YES / NO
3) Maharashtra University of Health Sciences, Nashik.
YES / NO
Page 5 of 5
(ii) Proposal for the Introduction New course in the existing Recognized Institute
Sr. No
Course Title (in Full Form)
Level of the course i.e. Degree, Name Diploma. Entry Intake Full of NOC level UG, Capacity Yearly / Time Affiliat From Proposed PG, specialty Qualific Semester ing state Fee Nursing ation Body Diploma Certificate etc.
(iii) Proposal for approval of seats intake of existing course/s or closure of institute.
Sr.No.
Title of Existing course/s
Name of Affiliating Body
Approved Intake of the course
Proposed variation in the approved Intake Addition
Deduction
Total Intake
(Note : For closing of institute, write zero intake in reduction column for all courses in the institute.) 2. Give justification of the proposal in terms of Aim, Need, Employment potential advantage of geographical location, etc. --------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 6 of 6
3) Give reason for closure of Institute: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------4) Whether NOC is obtained from concerned authority to close Institute/Course:
(Yes/No)
Name of the authority:- ----------------------------------------------------------------Letter No and Date: --------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 7 of 7
SECTION-III
Infrastructural facilities available for consideration of the proposal. 1. Land (for exclusive use of the proposed / existing Institution) (i) Location: (Metropolitan City/State Capital / District Head Quarter/Rural Area) (Tick mark whichever is applicable) (ii) Land: Whether owned by the applicant Society/Trust YES
If yes, then
NO
Acres
Hectors
2. Building (For exclusive use of the proposed /existing institution) (i) Whether the accommodation is available or would be provided owned by the Society / Trust or Rented? -----------------------------------a) If owned Existing building Name of the Institute & Programme Area exclusively reserved for proposed programme
Area
Sqm. Sqm.
b) If rented Building Area Lease Period in years (minimum 5 yrs.) Registered Lease document Registration number and Date NOC from concern authority to run the proposed courses in premises
Sqm. YES / NO
Note:- Minimum area of land sufficient to provide 7.0 sqm per candidate built up area of building. (ii) Total Built up area available exclusively for the proposed programme owned by the ---------------- sqm. (iii)Office area -----------------
sqm.
Page 8 of 8
3. Equipments. (i) Equipments which are available for the Conduct of the course/s
Rs _____________lakhs
(List of the equipment should be attached) (ii) Equipments, which shall be procured before starting of the course/s
Rs __________Lakhs
(List should be attached) (iii)Total investment already made for Equipment till today Rs. --------------------(iv) Proposed investment for Equipment Rs. ---------------------------------------------
4. List of Furniture: (Attach Separate lists for the following items.) Laboratory Class Room. Library etc. 5. Total Cost of Furniture: Rs.--------------------------------6. Library: Built up area: 1. No. Of books:
---------------------------------(in sqm) -----------------------------------------------------------
2. No. Of volumes: --------------------------------------------------------3. No. Of Journals: a) Technical/Professional: --------------------------b) Non Technical -------------------------------------4. Total investment on Books & Journals as on date (a) Books:
Rs.-----------------------------------------
(b) Journals:
Rs.:--------------------------------------Total Rs.-----------------------------------------
7. Staff: (i) Staff available in existing institute No. of Teaching Staff required as per norms & teaching staff available at present (Give information in separate sheet showing faculty wise i.e. Principal, Tutor, Professor. Asstt. Professor, Reader Lecturer etc. Also mention therein whether appointment is regular, Adhoc. Visiting) Total. Teaching load Theory ---------hrs, Practical/Workshop/Tutorials ------- hrs. (ii) Staff (Teaching & 'non-teaching) proposed to be appointed for New Institute, New course/s, Increase in Intake (Give in separate sheet)
Page 9 of 9
8. Students Amenities: Exclusive for the proposed course (i)Whether drinking water arrangements are available:
Yes/No
(ii) No. of water coolers:
No:
(iii) Whether separate Toilet facilities for Boys & Girls are made:
Yes/No
(iv) Whether common room facility, for Girls is available
Yes/No
(v) Mess Facility:
Yes/No
9. Financial position of the Society/Trust (i) Fixed Deposit of the Society/Trust: Rs. -------------------------- Lacks (Attach copy of the receipts) (ii) Overall investment proposed to be invested for the Technical Institute (Excluding Building) Rs. -----------------Lacks. (Phase Manner) (iii) Funds made available for the proposed course Rs._________lakhs
(iv) Last 3 years Audit report Audited report for last 3 Financial Year:-F.Y 2008-09/F.Y 2007-08/F.Y 2006-07 10. Clinical Facilities – Area : 1)
Name of the Hospital and Address : _____________________________ ___________________________________________________________ ___________________________________________________________
Name of the Hospital
2)
No. of Beds sectioned
Average occupancy per month
No. of Nursing School affiliated
Name of the Affiliated Hospital
:
Distance from College
Type of experience
___________________________
_____________________________
___________________________
_____________________________
Page 10 of 10
3)
___________________________
_____________________________
___________________________
_____________________________
___________________________
_____________________________
Classification of Beds : Beds
No. of Sanction
Occupancy
Medical Surgical /Orthopaedic Gynec/Obstretic Paediatric ENT/Opththalmic Psychiatric I. C. C. U. /I. C. U. Skin /infectious diseases Emergency / Casuality Any other specilization 3)
Whether student/patient ratio is maintain by institute
:
_____________________________
4)
Facility for community health nursing
:
_____________________________
a) Name and address Urban community
:
_____________________________
:
_____________________________
c) Distance from School / College of Nursing :
_____________________________
f) Student accommodation adequate hygienic : and safe ?
_____________________________
distance from School/College of Nursing. b) Name and Address Rural community
Page 11 of 11
SECTION-IV Declaration to be given by the chairperson and Secretary of the Society/Trust We on behalf of ____________________________________________________________ Undertake to comply with Terms & Conditions of the proposal. We attach herewith the following proofs/documents (Tick mark and give page numbers) Sr. No.
Description
(i)
Registration certificate of the Society/Trust from the Charity Commissioner
(ii)
List of the Equipment available for conducting the course/s
Page No.
(iii) List of Equipment which shall be procured before starting of the course/s (iv) List of faculty-wise teaching staff-appointed in existing Institute (v)
List of category-wise non-teaching staff appointed in the existing Institute.
(vi)
List of teaching & non-teaching staff proposed to be appointed for proposed New course/s and proposed increase in intake of the course/s
(vii) Proofs of the Land owned by the Society/Trust' (viii)
Proofs of the building available with the Society/Trust for exclusive use of the Proposed new or existing institute.
(ix) Copy of fixed Deposit in trust account Receipts not less than 5 lakh (x)
NOC from concerned authority to run the proposed courses
(xi)
Any other information or proof/document want to submit along with this proposal shall be noted below
1
Income Tax PAN Number of the Applicant/ Signatory
2
Audited Report for last 3 Financial Year :- 2006-07/2007-08/2008-09
3
Bank account passbook copy showing that the account is operative for the last three years
4
Architect plan approved by competent authority & Earmarked space for Institute & Hostel
We declare that no information has been concealed, false or misrepresented: If any information is found to be incorrect, the proposal shall be liable to be rejected by the Maharashtra Nursing Council. Mumbai. Page 12 of 12
Proposed fee structure (Including tuition and other fees) Sr. No.
Name of the course
Tuition Fees
Name & Signature of the Chairperson of the Society/Trust
Other Fees
Total Fees
Name & Signature of the Secretary of the Society/Trust
Three Copies should be addressed to following authorities:1) The Registrar, Maharashtra Nursing Council, Mumbai 2) The Director, Directorate of Medical Education & Research, 4th Floor, St’s Georges Hospital Campus, Mumbai 400 001.
3)
The Secretary, Medical Education& Drugs Department, Mantralaya, Mumbai 400 032.
Page 13 of 13
APPENDIX - A (Not to be attached to the proposal while submitting the proposal) Instruction for submission of proposals: 1 Copy of the prescribed application form would be available on the website http://www.maharashtranursingcouncil.org.in which can be downloaded through the download section of the website. The Payment of Rs 15000/- as a scrutiny fees should be paid through a Demand Draft drawn in favor of Registrar, Maharashtra Nursing Council, payable at Mumbai
2. The Proposal should be submitted in the prescribed Application Form in original with TWO additional Xerox copy addressed to the concerned authority acknowledging the receipt of the same. 3. Application form and its enclosures preferably are submitted in bound form along with
index and page numbers. 4. In the event, the Information and statements given by the applicant in the prescribed form are found incorrect / incomplete; the, application is liable to be rejected. Any future correspondence / information on such proposals shall not be entertained. 5. Inquiries or correspondence regarding status of the proposal during its processing shall not be entertained or replied. 6. Creditability of the proposal will be judged by requisite experience in running or managing higher Educational or Technical institutions. 7. Proposal will be considered as per the Technical manpower demands of the State Govt. and employment potential.
8.
Syllabus
and
other
contents
of
the
courses
are
available
on
website
www.maharashtranursingcouncil.org 9. The proposals will be accepted in the office of the council from 2nd May 2009 to 25th July 2009 between 10.30 am to 3 pm only for Academic Year 2010-2011. 10. The fresh proposals to be submitted by the management for each academic year, if last academic year proposal is declined by any of the competent authority. I.e. State Govt./ MNC/ INC
Page 14 of 14
APPENDIX-B (Not to be attached with the proposal while submitting the proposal) Terms and conditions for the proposals. 1. The proposal will be considered on no grant basis & claims for grant-in-aid for recurring or non- recurring expenditure will not be permitted by the Government at any time, at any stage and for any reasons. 2. As soon as the proposal is considered and sanction is accorded by the council the council will conduct the inspection for feasibility certificate then the proposals will be submitted with recommendation to the State Government for Essentiality certificate to The Secretary, Medical Education & Drugs Department, Mantralaya, Mumbai. 3. After approval of the proposal by the state Govt. management will get letter from the state govt. to remit the scrutiny fees. 4. The inspection will be conducted by the Director, Medical education & Research, Mumbai for essentiality certificate. 5. The state Govt. will issue essentiality certificate to the management 6. The management has to submit the Essentiality certificate to The Secretary, Indian Nursing Council, New Delhi Before 31st January or any stipulated extended period by them 7. The Management has to apply again along with scrutiny fees of Rs 15000.00 to the Maharashtra Nursing council for Permission to admit batch for Academic Year 2010-2011 8. Rules and regulation for admission to the course/s shall be observed as announced every academic year by Maharashtra Nursing Council for Diploma Programme or MUHS, Nashik for Degree & PG Programme. 9. Capitation fee or any other donation either in cash or in any kind will not be taken from the students or his/her parents by the Society for admission. 10. Sufficient accommodation shall be available with the society for running the institution and its course/s smoothly. 11. The proposal shall be in consonance with the policies, perspective plan & development plan of the State Govt. /Maharashtra Nursing Council, Mumbai. 12. The financial position of the applicant must be sound for investment in providing related Infrastructural and instructional facilities (institutional building, equipments, library, computers, Hostel facilities, student’s amenities etc.) as per the requirement of smooth running the courses and meeting the concerned recurring expenditure. 13. The proposal will be consider on the basic of academic monitoring reports for the last year for the existing institutes. 14. The management has to submit before permission to admit batch for undertaking to maintain all the norms & all the time in continues manner for running the programme.
Page 15 of 15
RECIEPT Received Date: -
Time:-
Name of the Programme:
Purpose: -Increase/ New Institute/ Existing Institute New Programme
No of copies: - 1 original & 2 additional Copies
Seal & Receivers Signature
Page 16 of 16
Application for proposal to start RANM/B.Sc./P.C. B.Sc./M. Sc. / specialty Nursing programme for Academic Year 2010-11 1. Name and Address of the Trust Society
________________________________ ________________________________ ________________________________ ________________________________
2. Name and Address of Chairperson:
________________________________ ________________________________ ________________________________ ________________________________ _________________ ________________________________
Telephone No. With STD Code E-mail 3. Name and Address of the prop. Institute:
4. Proposal Submitted for: (Tick Appropriate)
________________________________ ________________________________ ________________________________ ________________________________ New institute Increase seats
Page 1 of 1
New Course Closing of institute
INDEX
Sr. No.
Contents
1
Section-I Information about Society /Trust and the Institute.
2
Section-II; Information about the proposal for the Academic year 2010- -2011.
3
Section- III: Infrastructural facilities available.
4
Section-IV: Declaration to be given by the Chairperson and Secretary of the Society/Trust
5
Any Proofs/Documents attached to the proposal
Page No.
APPENDIX – A:-Instruction for submission of proposals:
6 APPENDIX-B: Terms and conditions for the proposals.
7
Note: Please don’t take print of this form and don’t fill it by hand. Use the word file and type all information in the form on Trust Letter head on the computer and then take a print.
Page 2 of 2
SECTION -1 A. Information about Society/Trust and the Institute 1. Name and Address of the Society/ Trust Name
Address:
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Pin Code Tel. No with STD Code Fax No E-mail address: 2. Registration No. & Date of the Society/Trust: ----------------------------------------------------With Charity Commissioner (Attach copy of Registration Certificate) 3. Name of the present chairperson and Secretary of the society / Trust along with tenure Chairperson : __________________________________________________ Secretary : __________________________________________________ Duration of Tenure:-from ______________________to______________________ Name of Trustees and Addresses (enclosed trust deed) Sr. No. 1 2 3 4 5 6 7
Name of Trustee
Address of Trustee
4. Name and Address of the proposed new or existing Institute Name: Address:
Pin code Phone No with STD Code Fax No E-mail address
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 3 of 3
5. Whether the above institute is already sanctioned or permitted for any course by any body Yes / No. --------If yes, then give below (i)Approval letter no. & Date: _______________________________________________ (ii)Approval letter no. & Date: ________________________________________ 6. Whether the Society/Trust runs any other educational Institutions/Courses? If yes, give the information in following table.
Sr. No.
Name of the Institutions & Addresses
Name & Entry Level of the Courses
Whether Recognized by the Government or Any other Body
Whether Aided by Central / State or Whether unaided
7. Course(s) with intake capacity and other details in the following table in respect of the existing (Government /council) Institute.
Title of Name of Sr. the Affiliating No. Course Body
Diploma/ Degree/ Certificate/ PD/ PGD/ AD
Yearly/ Semester
Duration
Sanctioned Intake
Year of Approval
Entry Level Qualification
(i) Fee charged for existing courses
Sr.No.
Name of the course
Tuition Fee
Page 4 of 4
Other fee
Total
SECTION-II
Information about the proposal for the academic year: 2010- 2011 Proposal is submitted for (Tick Mark whichever is applicable) (i) Permission of New Institution OR (ii) Introduction, of new course/s and or variation in intake in the existing Recognized Institute OR (iii) Closure of Institute.
Read before filling following table. 1) The courses recognized by MAHARASHTRA NURSING COUNCIL, Mumbai are available on website. (www.maharashtranursingcouncil.org) 1. (i) Proposal for Recognition of New Institute Level of the course i.e. Degree, Diploma. Entry Duration Name of UG, Sr. Course Title level Of the Affiliating PG, No (In full form) Qualificat Course Body specialty ion Nursing Diploma Certificate etc.
Intake Capacity
NOC From state Govt.
Total a) Whether the syllabus is existing for the proposed courses in –_______________________ 1) Maharashtra Nursing Council, Mumbai
YES / NO
b) Whether NOC is given by the concerned 2) Indian Nursing Council, New Delhi –
YES / NO
3) Maharashtra University of Health Sciences, Nashik.
YES / NO
Page 5 of 5
(ii) Proposal for the Introduction New course in the existing Recognized Institute
Sr. No
Course Title (in Full Form)
Level of the course i.e. Degree, Name Diploma. Entry Intake Full of NOC level UG, Capacity Yearly / Time Affiliat From Proposed PG, specialty Qualific Semester ing state Fee Nursing ation Body Diploma Certificate etc.
(iii) Proposal for approval of seats intake of existing course/s or closure of institute.
Sr.No.
Title of Existing course/s
Name of Affiliating Body
Approved Intake of the course
Proposed variation in the approved Intake Addition
Deduction
Total Intake
(Note : For closing of institute, write zero intake in reduction column for all courses in the institute.) 2. Give justification of the proposal in terms of Aim, Need, Employment potential advantage of geographical location, etc. --------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 6 of 6
3) Give reason for closure of Institute: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------4) Whether NOC is obtained from concerned authority to close Institute/Course:
(Yes/No)
Name of the authority:- ----------------------------------------------------------------Letter No and Date: --------------------------------------------------------------------------------------------------------------------------------------------------------------------
Page 7 of 7
SECTION-III
Infrastructural facilities available for consideration of the proposal. 1. Land (for exclusive use of the proposed / existing Institution) (i) Location: (Metropolitan City/State Capital / District Head Quarter/Rural Area) (Tick mark whichever is applicable) (ii) Land: Whether owned by the applicant Society/Trust YES
If yes, then
NO
Acres
Hectors
2. Building (For exclusive use of the proposed /existing institution) (i) Whether the accommodation is available or would be provided owned by the Society / Trust or Rented? -----------------------------------a) If owned Existing building Name of the Institute & Programme Area exclusively reserved for proposed programme
Area
Sqm. Sqm.
b) If rented Building Area Lease Period in years (minimum 5 yrs.) Registered Lease document Registration number and Date NOC from concern authority to run the proposed courses in premises
Sqm. YES / NO
Note:- Minimum area of land sufficient to provide 7.0 sqm per candidate built up area of building. (ii) Total Built up area available exclusively for the proposed programme owned by the ---------------- sqm. (iii)Office area -----------------
sqm.
Page 8 of 8
3. Equipments. (i) Equipments which are available for the Conduct of the course/s
Rs _____________lakhs
(List of the equipment should be attached) (ii) Equipments, which shall be procured before starting of the course/s
Rs __________Lakhs
(List should be attached) (iii)Total investment already made for Equipment till today Rs. --------------------(iv) Proposed investment for Equipment Rs. ---------------------------------------------
4. List of Furniture: (Attach Separate lists for the following items.) Laboratory Class Room. Library etc. 5. Total Cost of Furniture: Rs.--------------------------------6. Library: Built up area: 1. No. Of books:
---------------------------------(in sqm) -----------------------------------------------------------
2. No. Of volumes: --------------------------------------------------------3. No. Of Journals: a) Technical/Professional: --------------------------b) Non Technical -------------------------------------4. Total investment on Books & Journals as on date (a) Books:
Rs.-----------------------------------------
(b) Journals:
Rs.:--------------------------------------Total Rs.-----------------------------------------
7. Staff: (i) Staff available in existing institute No. of Teaching Staff required as per norms & teaching staff available at present (Give information in separate sheet showing faculty wise i.e. Principal, Tutor, Professor. Asstt. Professor, Reader Lecturer etc. Also mention therein whether appointment is regular, Adhoc. Visiting) Total. Teaching load Theory ---------hrs, Practical/Workshop/Tutorials ------- hrs. (ii) Staff (Teaching & 'non-teaching) proposed to be appointed for New Institute, New course/s, Increase in Intake (Give in separate sheet)
Page 9 of 9
8. Students Amenities: Exclusive for the proposed course (i)Whether drinking water arrangements are available:
Yes/No
(ii) No. of water coolers:
No:
(iii) Whether separate Toilet facilities for Boys & Girls are made:
Yes/No
(iv) Whether common room facility, for Girls is available
Yes/No
(v) Mess Facility:
Yes/No
9. Financial position of the Society/Trust (i) Fixed Deposit of the Society/Trust: Rs. -------------------------- Lacks (Attach copy of the receipts) (ii) Overall investment proposed to be invested for the Technical Institute (Excluding Building) Rs. -----------------Lacks. (Phase Manner) (iii) Funds made available for the proposed course Rs._________lakhs
(iv) Last 3 years Audit report Audited report for last 3 Financial Year:-F.Y 2008-09/F.Y 2007-08/F.Y 2006-07 10. Clinical Facilities – Area : 1)
Name of the Hospital and Address : _____________________________ ___________________________________________________________ ___________________________________________________________
Name of the Hospital
2)
No. of Beds sectioned
Average occupancy per month
No. of Nursing School affiliated
Name of the Affiliated Hospital
:
Distance from College
Type of experience
___________________________
_____________________________
___________________________
_____________________________
Page 10 of 10
3)
___________________________
_____________________________
___________________________
_____________________________
___________________________
_____________________________
Classification of Beds : Beds
No. of Sanction
Occupancy
Medical Surgical /Orthopaedic Gynec/Obstretic Paediatric ENT/Opththalmic Psychiatric I. C. C. U. /I. C. U. Skin /infectious diseases Emergency / Casuality Any other specilization 3)
Whether student/patient ratio is maintain by institute
:
_____________________________
4)
Facility for community health nursing
:
_____________________________
a) Name and address Urban community
:
_____________________________
:
_____________________________
c) Distance from School / College of Nursing :
_____________________________
f) Student accommodation adequate hygienic : and safe ?
_____________________________
distance from School/College of Nursing. b) Name and Address Rural community
Page 11 of 11
SECTION-IV Declaration to be given by the chairperson and Secretary of the Society/Trust We on behalf of ____________________________________________________________ Undertake to comply with Terms & Conditions of the proposal. We attach herewith the following proofs/documents (Tick mark and give page numbers) Sr. No.
Description
(i)
Registration certificate of the Society/Trust from the Charity Commissioner
(ii)
List of the Equipment available for conducting the course/s
Page No.
(iii) List of Equipment which shall be procured before starting of the course/s (iv) List of faculty-wise teaching staff-appointed in existing Institute (v)
List of category-wise non-teaching staff appointed in the existing Institute.
(vi)
List of teaching & non-teaching staff proposed to be appointed for proposed New course/s and proposed increase in intake of the course/s
(vii) Proofs of the Land owned by the Society/Trust' (viii)
Proofs of the building available with the Society/Trust for exclusive use of the Proposed new or existing institute.
(ix) Copy of fixed Deposit in trust account Receipts not less than 5 lakh (x)
NOC from concerned authority to run the proposed courses
(xi)
Any other information or proof/document want to submit along with this proposal shall be noted below
1
Income Tax PAN Number of the Applicant/ Signatory
2
Audited Report for last 3 Financial Year :- 2006-07/2007-08/2008-09
3
Bank account passbook copy showing that the account is operative for the last three years
4
Architect plan approved by competent authority & Earmarked space for Institute & Hostel
We declare that no information has been concealed, false or misrepresented: If any information is found to be incorrect, the proposal shall be liable to be rejected by the Maharashtra Nursing Council. Mumbai. Page 12 of 12
Proposed fee structure (Including tuition and other fees) Sr. No.
Name of the course
Tuition Fees
Name & Signature of the Chairperson of the Society/Trust
Other Fees
Total Fees
Name & Signature of the Secretary of the Society/Trust
Three Copies should be addressed to following authorities:1) The Registrar, Maharashtra Nursing Council, Mumbai 2) The Director, Directorate of Medical Education & Research, 4th Floor, St’s Georges Hospital Campus, Mumbai 400 001.
3)
The Secretary, Medical Education& Drugs Department, Mantralaya, Mumbai 400 032.
Page 13 of 13
APPENDIX - A (Not to be attached to the proposal while submitting the proposal) Instruction for submission of proposals: 1 Copy of the prescribed application form would be available on the website http://www.maharashtranursingcouncil.org.in which can be downloaded through the download section of the website. The Payment of Rs 15000/- as a scrutiny fees should be paid through a Demand Draft drawn in favor of Registrar, Maharashtra Nursing Council, payable at Mumbai
2. The Proposal should be submitted in the prescribed Application Form in original with TWO additional Xerox copy addressed to the concerned authority acknowledging the receipt of the same. 3. Application form and its enclosures preferably are submitted in bound form along with
index and page numbers. 4. In the event, the Information and statements given by the applicant in the prescribed form are found incorrect / incomplete; the, application is liable to be rejected. Any future correspondence / information on such proposals shall not be entertained. 5. Inquiries or correspondence regarding status of the proposal during its processing shall not be entertained or replied. 6. Creditability of the proposal will be judged by requisite experience in running or managing higher Educational or Technical institutions. 7. Proposal will be considered as per the Technical manpower demands of the State Govt. and employment potential.
8.
Syllabus
and
other
contents
of
the
courses
are
available
on
website
www.maharashtranursingcouncil.org 9. The proposals will be accepted in the office of the council from 2nd May 2009 to 25th July 2009 between 10.30 am to 3 pm only for Academic Year 2010-2011. 10. The fresh proposals to be submitted by the management for each academic year, if last academic year proposal is declined by any of the competent authority. I.e. State Govt./ MNC/ INC
Page 14 of 14
APPENDIX-B (Not to be attached with the proposal while submitting the proposal) Terms and conditions for the proposals. 1. The proposal will be considered on no grant basis & claims for grant-in-aid for recurring or non- recurring expenditure will not be permitted by the Government at any time, at any stage and for any reasons. 2. As soon as the proposal is considered and sanction is accorded by the council the council will conduct the inspection for feasibility certificate then the proposals will be submitted with recommendation to the State Government for Essentiality certificate to The Secretary, Medical Education & Drugs Department, Mantralaya, Mumbai. 3. After approval of the proposal by the state Govt. management will get letter from the state govt. to remit the scrutiny fees. 4. The inspection will be conducted by the Director, Medical education & Research, Mumbai for essentiality certificate. 5. The state Govt. will issue essentiality certificate to the management 6. The management has to submit the Essentiality certificate to The Secretary, Indian Nursing Council, New Delhi Before 31st January or any stipulated extended period by them 7. The Management has to apply again along with scrutiny fees of Rs 15000.00 to the Maharashtra Nursing council for Permission to admit batch for Academic Year 2010-2011 8. Rules and regulation for admission to the course/s shall be observed as announced every academic year by Maharashtra Nursing Council for Diploma Programme or MUHS, Nashik for Degree & PG Programme. 9. Capitation fee or any other donation either in cash or in any kind will not be taken from the students or his/her parents by the Society for admission. 10. Sufficient accommodation shall be available with the society for running the institution and its course/s smoothly. 11. The proposal shall be in consonance with the policies, perspective plan & development plan of the State Govt. /Maharashtra Nursing Council, Mumbai. 12. The financial position of the applicant must be sound for investment in providing related Infrastructural and instructional facilities (institutional building, equipments, library, computers, Hostel facilities, student’s amenities etc.) as per the requirement of smooth running the courses and meeting the concerned recurring expenditure. 13. The proposal will be consider on the basic of academic monitoring reports for the last year for the existing institutes. 14. The management has to submit before permission to admit batch for undertaking to maintain all the norms & all the time in continues manner for running the programme.
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RECIEPT Received Date: -
Time:-
Name of the Programme:
Purpose: -Increase/ New Institute/ Existing Institute New Programme
No of copies: - 1 original & 2 additional Copies
Seal & Receivers Signature
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