BAIET-2015 - DY Patil University

BAIET-2015
APPLICATION FORM
B.Ed. ALL INDIA ENTRANCE TEST (BAIET-2015)
School of Education
Application
Number
D. Y. PATIL UNIVERSITY
(Established under section 3 of the UGC Act, 1956 vide notification no. F.9.21/2000-U.3
Dated 20.06.2002 of the Govt. of India)
Accredited by NAAC with CGPA of 3.35 on Four Point Scale at ‘A’ Grade
Navi Mumbai
Important Instructions:
• Please read the instructions given in the Prospectus for filling the form
• Use blue or black ball point pen for filling the form.
• Tick the appropriate boxes.
• All entries in this form must be in CAPITAL LETTERS only.
Paste your
recent (not
more than 3
month old)
Photograph
here
•.BAIET 2015 will be conducted on 2nd -June - 2015. Time-11.00am to 12.00 noon,
venue- School of Education, D.Y.Patil University, Sector-7, Nerul, Navi Mumbai.
Hall tickets will be available on centre on same day
1.Name of the candidate in full
First Name
Surname
2. Date of Birth
D D
M M Y
Father’s /Husband’s Name
Y Y Y
3. Sex
Male
Female
4. Category:
a) General
Reserved
b) SC
ST
OBC
NT
Others, Please Specify
5. Address for Correspondence:
State
6. Permanent Address:
Pin code
DT
Pin code
State
7. Telephone No. (with STD Code)
Fax Number (with STD Code)
Mobile No.
8. E-mail ID
9. Optional Subjects for Practice Teaching: Choose any two out of the following: (one should
preferably match a major subject offered at the graduation level.)
A - English, Marathi, Hindi, Sanskrit, Science, Economics
B Mathematics,
History, Geography, Commerce
10. Medium: English / Marathi / Hindi
11. Name of the University of the qualifying examination
Year
State
Medium
12. Marks obtained at the final year Graduation examination:
Sr.
No.
1
2
3
4
5
6
Subject
Marks
obtained
Out of
Minimum
for passing
13. Percentage of marks at the final year Graduation examination.
%
14. Post-Graduation Degree (only if completed) University
Year
State
Year
Subject
Marks Obtained
15. Details of Test Fee paid
Mode of payment
Out of
D.D.
In case of payment by Demand Draft:
Name of Bank:
Issuing Branch:
D.D. No:
(Enclose DD – do not staple)
Date:
Amount:
16. Signature of Candidate
17. Declaration:
I hereby declare that the information given above by me is correct and true to the best of
my knowledge and belief. I have not suppressed any information. I am aware that I shall be liable
to civil / criminal action by the Competent Authority against me if any information given above
by me is found to be incorrect or false.
Place:
Date:
Signature of the Candidate
I have noted the above declaration given by the candidate and I agree with it.
Signature of Parent / Guardian
BAI ET- 2015
HALL TICKET
ALL INDIA ENTRANCE TEST FOR SELECTION OF
CANDIDATES FOR ADMISSION TO B.ED.COURSE
Date of Exam:.
D.Y.PATIL UNIVERSITY
(Established under section 3 of the UGC Act, 1956 vide notification no. F.9.21/2000-U.3
Dated 20.06.2002 of the Govt. of India)
Accredited by NAAC with CGPA of 3.35 on Four Point Scale at ‘A’ Grade
Navi Mumbai
Hall Ticket Number
Name and address of the Entrance Test Centre allotted to the candidate.
D.Y. Patil University
D.Y.Patil Vidyanagar, Nerul, Navi Mumbai 400 706
Paste your recent
Photograph
Candidate’s Signature**
Invigilator’s
Signature**
Coordinator
Sign on the photograph
** To be signed in the presence of the invigilator in Examination Hall
Note : The candidate should fill in his /her name and address, affix recent photograph in the space provided in the Hall Ticket and
Attendance Sheet and send them along with the Application Form.
BAIET-2015
ATTENDANCE SHEET
ALL INDIA ENTRANCE TEST FOR SELECTION OF
CANDIDATES FOR ADMISSION TO B.ED.COURSE
Date of Exam:.
D.Y.PATIL University
(Established under section 3 of the UGC Act, 1956 vide notification no. F.9.21/2000-U.3
Dated 20.06.2002 of the Govt. of India)
Accredited by NAAC with CGPA of 3.35 on Four Point Scale at ‘A’ Grade
Navi Mumbai
Name and address of the Candidate
Application Number
Hall Ticket Number
Name and address of the Entrance Test Centre
allotted to the candidate.
D.Y. Patil University
D.Y.Patil Vidyanagar, Nerul, Navi Mumbai
400706
Candidate’s Signature**
Invigilator’s Signature**
** To be signed in the presence of the invigilator in Examination Hall
Note : The candidate should fill in his /her name and address, affix recent photograph in the space provided in the Hall Ticket and
Attendance Sheet and send them along with the Application Form.
Paste your
recent
Photograph
Sign on the
photograph
BAIET- 2015
ALL INDIA ENTRANCE TEST FOR SELECTION OF
CANDIDATES FOR ADMISSION TO B.ED.COURSE
RECEIPT
D.Y.PATIL University
(Established under section 3 of the UGC Act, 1956 vide notification no. F.9.21/2000-U.3
Dated 20.06.2002 of the Govt. of India)
Accredited by NAAC with CGPA of 3.35 on Four Point Scale at ‘A’ Grade
Navi Mumbai
Note : Candidates should fill both the copies of this format. The copy marked “Candidate’s
Copy” will be sent to as receipt for payment of Entrance Test Fee.
Name & address of the CandidateApplication Number
Particulars of the Demand Draft:
Name of the Bank
Issuing Branch
D.D.No
Date
Amount
Received the Entrance Test fee as mentioned above.
Date:Stamp
Accounts Clerk/Cashier
Note : Candidates should fill both the copies of this format. The copy marked “Candidate’s
Copy” will be sent to as receipt for payment of Entrance Test Fee.
Name & address of the CandidateApplication Number
Particulars of the Demand Draft:
Name of the Bank
Issuing Branch
D.D.No
Date
Amount
Received the Entrance Test fee as mentioned above.
Date:Stamp
Accounts Clerk/Cashier