(Regd. An Ex-Officer Enterprise) JOBS INTER + JOBS X XXvizagdefenceacademy.com/pdf/VDA_Application.pdfFILL ALL COLUMNS IN BLOCK CAPITAL LETTERS 7.B Chest (after expansion) Cm 6. Weight

(Regd. An Ex-Officer Enterprise) 104 Area Marripalem Chinagantyada

Head Office: 104 Area, Visakhapatnam - 530 007

Application No.: Admission No. :

ADDPHOTO

11. Place of Admission :

3. Name of the Candidate (as in Matriculation Certificate) :

2. Application for Advanced Coaching :

4.

(Month)(Date) (Year)

5. HeightDate of Birth :(as in Matriculation Certificate)

Xth T / M toInter E / M NavyAir

force

Cm.

FILL ALL COLUMNS IN BLOCK CAPITAL LETTERS

7.B Chest(after expansion)

Cm

6. Weight

Kg Cm

7.A Chest(before expansion)

Left Right Left Right68. EYE SIGHT 6 6 6

FAMILY PARTICULARS RESPONSIBLE TO STUDENTFather Name : ........................................................................

Occupation : ........................................................................

Date of Birth : .........................................

Cell :FatherPhoto

Signature

0

Mother Name : ........................................................................

Occupation : ........................................................................

Date of Birth : .........................................

Cell :MotherPhoto

Signature

0

Local Guardian Name :..................................................................

Occupation : ........................................................................

11.

e-mail :

Home Ph :.............................................................Mobile : 0

Local, Guardian Address :.......................................................................................................................

.......................................................................................................................

.......................................................................................................................

.......................................................................................................................

.......................................................................................................................

LocalGuardian

Photo

Signature

10. Permanent Home Address :

State : ..............................................................Pin Code :Home Ph :...............................STD:Mobile : 0

9. Last Studied School / College Details10th SSC CBSE ICSE Inter (MPC)

Telugu English Hindi Others

Medium of Study

Cumulative Grade Point Average (CGPA) Marks Range_________________________

10th Hall Ticket No. _______________________________________________________

Name of the School/College _______________________________________________

Address of School _______________________________________________________

Without Glasses With Glasses

Junior Senior E / M T / M ArmyNDAOnly ALL

/1000

INTER + JOBS

INTER+

JOBS

AadharNo.

: 2 :

Caution : Selection in Armed Forces is Fair and on Merit only. Candidates should not fall prey to unscrupulous persons posing as Recruitment agents.For complaint against such persons, candidates must approach the Director, Vizag Defence Academy Or Phone : 09701775599

16. CONSENT FORM(Application in respect of candidates both above

and below 18 years of age)I, ............................................................. son /

father / guardian of ......................................................whose date of birth is ................................................do hereby give my consent for myself / son / ward toappear in the training of physical / medical tests, asprescribed for selection in the Indian Air Force, Navyand Army at my own risk. I am aware that nocompensation in any form shall be claimed, in respectof injuries if any, sustained by my self/ son / ward,during such test. and training.

Signature ............................................................................................Name of Candidate / Parent / Guardian .......................................................Relationship with the Candidate ...................................................................Date : ...............................

College bears no responsibility for loss of money, cellor any personal belongings. Have a strong Trunk Boxof gauge '18' and use only Godrej Lock. Keep yourbelonging Locked in Trunk Box and carry keys 24x7.Dont trust your friends, dont lend your money or cellphone or any of your belongings.Note : only black & white cell phone allowed,colour & camera cells not allowed.

17. CELL, MONEY AND PERSONAL BELONGINGS :

18. Certificates to be enclosed Originals:(Each Two Sets of Photo copies)

a) SSC or equivalent marksmemo (Original & One Xerox)

c) Study Certificate from VIto X / Jr.Inter (Original)

e) Passport sizephotos : 6 Nos.

g) Migration and PassCertificate (Original) (forA.I.S.I.C; I.C.S.E; andC.B.S.E.students)

b) Transfer and conductCertificate (Original)

d) Certificate for otherreservation claimed inOriginal (NCC / Sports /Ex-service / Fatherless boy)

f) Residence / NativityCertificate in original forall students)

h) Caste Certificate,if any.

14. Whether any of your family members is / was a student in VDA Institutions.

Particulars:

Name : ..............................................................................................

Year : ..............................................................................................

College / Place: ..............................................................................................

Job Selected : ..............................................................................................

Residential / Day-Scholar : .................................................................................

I will follow, into and in letter and in spirit, the descipline ofthe institution. I shall not do any thing which violates the disciplineof the institution. I will abide by the rules and the regulations of theinstitution. I will co-operate with the authorities in all aspects. I willnot question the action of the college authorities, even if they cancelconcessin or give punishment to me including that of issuing. T.C.to me, in the event of my misbehaviour. I agree that my actionsoutside the campus will not be binding on the college and my parentsand I will be legally liable for the consequences of my actions. Ihave personally seen and satisfied myself with the facilities in thecollege and I am willing to join on my own.

15. Undertaking by the Student :

BY ORDER

SELECTION :I KNOW THAT SELECTION IN THE

DEFENCE FORCES IS ABSOLUTELYFREE AND FAIR NO MONEY ISREQUIRED TO BEPAID TO ANY

AGENCY OR TOUTS FORSELECTIONS

READ & UNDERSTOOD

Signature of the parentDate :

I will co-operate with the college management in allmatter pertaining to the good behaviour of my son and othermatters of discipline. I will not question the management withregard to their decision of my son. I will not question the collegefor my son`s actions outside the campus. I will be legally liablefor the acts of omission or commission of my son. I will pay allthe fee and pocket money dues I owe to the college as decidedby the management. Even in case of any problem or dispute, Iagree to get legal redress only in the courts of law inVisakhapatnam Municipal limits. All the details furnished by meand all the statements made by me in the application are trueto the best of my Knowledge . I have personal knowledge ofthe veracity of all the details furnished by me. I agree thatmanagement has the authority withhold any documents for issueat any such time if the fee / other dues to the college areoutstanding or unpaid.

19. Undertaking by the parent :

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AB+ ve AB - ve O + ve O - ve12. Blood Group

13. Nationality : Religion :

Caste : Sub Caste :

: 3 :


I accept the terms & conditions Iaid by the institution for the fees structure. I am aware of deduction and refundformalities of the structure of the fee (I have referred to the format given below.)

READ & UNDERSTOOD

Signature of the ParentDate :

READ & UNDERSTOOD

AP Residential Students : Before 31 Jul of that academic year, . 45,000/- will be deducted.Before 10 Aug of that academic year, . 52,500/- will be deducted.Before 10 Oct of that academic year, . 65,000/- will be deductedand after that, no fee will be refunded.

Inter State Residential : Before 31 Jul of that academic year . 65,000/- will be deducted.Students Before 10 Aug of that academic year, . 75,000/- will be deducted.

Before 10 Oct of that academic year, . 95,000/- will be deductedand after that, no fee will be refunded.

Thanking You.

1. All fees concession enjoyed of any category shoud be fullypaid when student get to defence job

2. Fee Concession students are not allowed to transfer toanother college for IInd Year Intermediate studies (Becauseconcesion is a privilege that is given to a group of studentsat the cost of organization money.) However, the studentmay be permitted to transfer on medical grounds afterpaying the concession fees which he has enjoyed in Istyear Intermediate.

3. Fee concession of any category will be cancelled if a studentescapes from the campus or hostel without permission ofthe campus administration and also . 5,000/- fine will becollected during the issue of hall ticket.

4. Fee concession students of any category should completethe fee payment by 10th November, If not concession willbe withdrawn.

5. Fee concessions of any category will be withdrawn fromthe students who involve in damaging the property ofcollege or indulged in thefts. Also such students will bedebarred.

Parent / Guardian Signature

Date :DirectorVizag Defence Academy



22.

21. FEE REFUND FOR RESIDENTIAL STUDENTS

FEE CONCESSION : CONDITIONS

From the Date of Joining upto

6. Fee concession of any category will be withdrawn fromthe students who involve or provoke fights in hostel,College or street, either with VDA Students, VDAemploys or with outers.

7. Fee concession of any category will be withdrawn fromstudent if the student found moving in unauthorisedplaces.Example : RK Beach, Rushikonda Beach etc.

8. Fee Concession of all categories will be withdrawn forthe students absent for any of the defence jobsselections purposefully.

9. All the concession student has to puchase one setTelugu Academy Text Book and bring his own bed.

10. Dear Parent make your son join only if you agree to theabove conditions.

11. Vat Tax is compulsory for all students in both Ist and2nd year.

Note:1. Only 50% of the initial payment willbe refunded before August 10th of thatacademic year, if the student does not joinowing to any reasons thereof andthereafter any claims of refund will not beentertained. (Moreover the refunding ofintial 50% payment is not applicable forthose day Scholars who have paid fee ofany nature below . 2,000/- and hostelersbelow . 5,000/- under any cirumstances)2. Original receipts must be producedalong with a request on plain paper whilepreferring settlements, refunds ortransfers.

I undertake to furnish the names of the authorised visitors alongwith their photos at the of admission my son. The visitors can bepermitted to visit my son. I shall not request the management topermit any visitor than those whose names will be furnished byme to see my son. I am informed that the college censor lettersof my son and I have no objection to that. I am in the knowledgethat fee paid towards admission can`t refunded. In case ofcancellation of admission, account settlement is as per conditionmentioned by the management as below. After satisfying myself

20. FOR RESIDENTIAL STUDENTS the facillties, conditions and rules/regulation of the college I amwillingly admit my child. I am willing to permit my child to be letout by the institution under permission and the college shall notbe responsible for his out-of -the campus behaviour or non-return.If my ward escapes from the campus without permission of thecampus administration, I will not hold the College responsibleand shall bear the responsibility on my self. I am informed thatsuch actions on the part of the student attract cancellation of feeconcession and also expulsion from residential campus. I aminformed by the management that cell phones should not bebrought into the campus and class room.

: 4 :


VIZAG DEFENCE ACADEMYFEE STRUCTURE FOR ACADEMIC YEAR 2015-2016

FEE DETAILS FOR INTER (M.P.C.) + JOBS

NOTENOTENOTENOTENOTE1. Vizag Defence Academy is not a

laison office, it provides goodcoaching for selection test inNavy, Air Force and Army.

2. Medicals: The academy does notgive guarantee that the boys willbe medical fit at the Service Medi-cal Board.

3. Hall Ticket: Getting hall Ticket isindividual’s luck and responsibil-ity.

4. Selection: In the Defence ForcesSelection is absolutely free andfair. It is individuals Hard work.

5. Number of Job Attempts: Timeto time policies for recruitmentstandard changes, accordinglyone has to face for it.

6. No FEES will be refunded on anyof the above clauses.

DIRECTOR

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VIZAGDEFENCE ACADEMY

RESIDENTIAL STUDENT :Registration + Medical : . 1000/-

TOTAL FEE for A.P. : . 70,000/- (At the Time of Joining)

( . 35,000/- for Lodging & Boarding Fee and .35,000/- coaching fee)

TOTAL FEE for OTHER STATE : . 1,00,000/- (At the Time of Joining)

( . 50,000/- for Lodging & Boarding Fee and .50,000/- coaching fee)

Note: If Hall Ticket not received due to any reason Job CourseResidential students will be given free one month ResidentialCoaching for next selection.

FEE DETAILS FOR JOB COURSE

FEE FOR FIVE MONTHSJOB COURSE : JUN TO 10NOV2015

(100% Job Guaranteed)

1. Registration + : . 1000/-Medical

2. Tuition Fee Total : .1,30,000/-+for Boarding, Lodging (V(V(V(V(VAAAAAT TT TT TT TT TAX)AX)AX)AX)AX)and College Fee

1st Term : . 65,000/-(At the time of Admission)

2nd Term : . 65,000/-(By 10th November)

3. Security Deposit : . 1000/-

23. RESIDENTIAL FOR A.P. & TELANGANA STUDENTS / FOR OTHER STUDENTS

NOTE : . 12,000/- FEES FOR NDA OFFICERS PROGRAMME DURING SUMMER HOLIDAYS IN APR & MAY

25 26

ATTENTION :ATTENTION :ATTENTION :ATTENTION :ATTENTION : PPPPPAAAAAY FEES IN COLLEGE ACCOUNTS SECTION AND MAKE SURE TY FEES IN COLLEGE ACCOUNTS SECTION AND MAKE SURE TY FEES IN COLLEGE ACCOUNTS SECTION AND MAKE SURE TY FEES IN COLLEGE ACCOUNTS SECTION AND MAKE SURE TY FEES IN COLLEGE ACCOUNTS SECTION AND MAKE SURE TO OBTO OBTO OBTO OBTO OBTAINAINAINAINAINPROPER RECEIPTPROPER RECEIPTPROPER RECEIPTPROPER RECEIPTPROPER RECEIPT.....FEES PFEES PFEES PFEES PFEES PAID WITHOUT PROPER RECEIPTAID WITHOUT PROPER RECEIPTAID WITHOUT PROPER RECEIPTAID WITHOUT PROPER RECEIPTAID WITHOUT PROPER RECEIPT, COLLEGE BEARS NO RESPONSIBILITY, COLLEGE BEARS NO RESPONSIBILITY, COLLEGE BEARS NO RESPONSIBILITY, COLLEGE BEARS NO RESPONSIBILITY, COLLEGE BEARS NO RESPONSIBILITYBEABEABEABEABEAWWWWWARE OF TARE OF TARE OF TARE OF TARE OF TOUTSOUTSOUTSOUTSOUTS

DEGREE + JOBS

. 2000/-

.1,90,000/-+ (V (V (V (V (VAAAAAT TT TT TT TT TAX)AX)AX)AX)AX)

. 95,000/-

. 95,000/-

. 2500/- (Refundable after course completion)

4. Note : 10% Fee increase for second year5. CBSE/ICSE and Other State Board Students Board Forwarding

fees .600/- to be paid as per IPE Board Rules free for students

24. HOW TO APPLY EPASS ONLINE ? EPASSOnline fresh registrations for fee reimbursement scholarshipsfor students who pursue college courses for the academicyear 2014-2015 will be commenced soon. The scholarshipapplication process has been made fully online by the SocialWelfare Department every year, in the online system, nostudent can enter his name as Student records will be fetchedfrom SSC / Inter servers based on the application SSC ID.For the academic year 2014-2015, students can apply onlinefor fresh scholarships on the e-pass website soon after therelease of notification. applicants belonging to SC / ST withfamily income of less than 2 lakh per annum, BC studentsbelonging to BC / EBC / DW / MW with family income of lessthan 1 lakh per annum are eligible to apply for feesreimbursement scholarships. all the applicants must andshould submit an income declaration form to the MRO to obtainan income certificate.

Requirements for online application of EPASS SSC ID (Hall Ticket) Number to access the application.Caste Certificate. Income Certificate The following documentsmust be scanned & uploaded on the website. Caste Certificate.Income Certificate (vide reference 2nd , 3rd and 4th cited)Latest photograph. Savings bank account number in the nameof the student and joint account for students below 18 yearsi.e. in name of student and parent (The first page of the passbook showing name, account number & IFSC Code must bescanned & uploaded) Further the following fields aremandatory in the online application form-- E-mail account.Mobile Number (either in Student / Parent / Relatives Number)Bank account no of any scheduled bank having online facility,with correct IFSC code.

: 5 :


MEDICAL CASE SHEETADD

PHOTO2

Name ___________________________________________

Date of Birth

A) ANTHROPAMETRIC DATE :

1) Height : Cm. 2) Weight : Kg.

3) Chest Circumference : _______________________________________4) Minimum Range of Chest Expa. : _______________________________________5) Blood Group :

B) GENERAL EXAMINATION :1) Built : ________________________________________2) Nourishment : ________________________________________3) Blood Pressure : ________________________________________4) Respiratory Rate : ________________________________________

C) EXAMINATION OF EYES :1) Any Deformity : ________________________________________2) Vision : ________________________________________a) Visual Acuity : ________________________________________b) Visual Field : ________________________________________c) Colour Blindness : ________________________________________

D) EXAMINATION OF EARS :1) Hearing : ________________________________________2) Active Infection of Ears : ________________________________________

E) EXAMINATION OF NOSE :1) Any Deformity : ________________________________________2) Active Infection : ________________________________________

F) EXAMINATION OF ORAL CAVITY :1) Number of Teeth : ________________________________________2) Any Deformity : ________________________________________

G) COMMUNICABLE DISEASES : ________________________________________H) CARDIO VASCULAR SYSTEM : ________________________________________J) CENTRAL NERVOUS SYSTEM : ________________________________________K) SWEATING : ________________________________________L) SURGICAL DEFORMITIES : ________________________________________

1) Limbs : ________________________________________2) Spine : ________________________________________3) Flat Foot : ________________________________________4) Hernial Orifices : ________________________________________5) Any other Abnormality : ________________________________________

M) OTHER INFORMATION : ____________________________

Date : Signature ofVDA Doctor

MEDICAL NOTE : The Academy does not give guaranteethat the boys will be medical fit at the service medical boardat the time of selection. Our medical Test is only to reducethe medical rejections at the selection boards. Signature of Parent Signature of Student

READ & UNDERSTOOD#·~$ ns¡∆+ #˚düT≈£îHêïqT

27

A +ve A - ve B +ve B - ve

AB+ ve AB -ve

O + ve O - ve

MEDICAL EXPENDITUREINCURED BY STUDENT :I st Year

II nd Year

28.

d d m m y y y y

: 6 :


AT THE TIME OF JOINING

1.Dhobi Charges : 2015 - 16 Academic Year

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

2.IPE Board Exam Fees :

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

I st Year

4.Fees Paid Towards Books 1st Year :

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

3.CBSE / ICSE and Other State Students Board ForwardingFees Rs. 600/- to be paid as per IPE Board Rules :Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

1.Dhobi Charges : 2015 - 16 Academic Year

Paid . ________________R. No._____________

Date :__________ Principal Sign. ______________2.IPE Board Exam Fees :

Paid . ________________R. No._____________

Date :__________ Principal Sign. ______________

II nd Year

3.Fees Paid Towards Books 2nd Year :

Paid . ________________R. No._____________

Date :__________ Principal Sign. ______________

1.VAT Tax For 1st Year :

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

Fees Paid at the Time of Leaving College

2.VAT Tax For 2nd Year :

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________3.Damage Charges of any Property :

Paid . ________________________________

R. No.________________ Date :____________

Principal Sign. ____________________________

29.

5.Dental Clinical Charges :

Paid . 300/-

R. No.________________ Date :____________

Principal Sign. ____________________________

RED ENTRY CONFIDENTIAL REPORTS.No.

1. Date ..................

Campus InchargeSign. Parent Sign. Director Sign.

IN-DISCIPLINARY NOTE

Date : ___________________ Signature of Parent

READ & UNDERSTOODô|’ ìã+<Ûäq\T #·~$ ns¡∆+#˚düT≈£îHêïqT.

CAUSE FOR RED ENTRY :Absconding ClasssesStudent escapes from the campus or hostel withoutpermissionWho involve in damaging the property of college orindulging in thefts.Students absent for any of the defence jobs selectionspurposefully.

The student found moving in unauthorised places.Example : RK Beach, Rushilkonda Beach etc.Who involve or provoke fights in hostel, college orstreet, either with VDA Students, VDA employs orwith outers.Causes for Fee Concession Cancellation :Any Two Red EntriesCauses for Issuing T.C.:Any 3 Red Entries Long Absenting

2. Date ..................


3. Date ..................


4. Date ..................


5. Date ..................


6. Date ..................


7. Date ..................


8. Date ..................


9. Date ..................


FOR OFFICE USE ONLY

DETAILS OF PAYMENT

Payment of Fees (Amount)

Other informationBy Director

: 7 :

Date Rupees in Words Receipt No. Director / Principal Sign with dateIST YEAR AGREED FEES :

2ND YEAR AGREED FEES :

Registration Fees :

Xth : _________________

CBSE : _________________

ICSE : _________________

Jn. Inter MPC : _______________ 470

Inter MPC : _______________ 1000

GRADE: POINTS (GP)

CourseName ...................................................

APPLICATION PROCESSED AND ADMISSION APPROVED BY : ...................................................................................

C. . .............. PAID TO ............................................................ DATE : ................... DIR SIGN .................

Name : ........................................................................................................................................

T.M.E.M.D/SRES

: 8 : STATEMENT OF MARKS

ADDPHOTO

3

Name : _________________________________________________

Father Name : _________________________________________________

Mother Name : _________________________________________________

Bearing Roll No. :

Belonging to School : ________________________________________________________________

has appeared : SSC CBSE ICSE

SSC ICSE CBSE

FIRST LAUNGUAGE(TELUGU)

THIRD LAUNGUAGE(ENGLISH)

MATHE MATICS

GENERAL SCIENCE

SOCIAL STUDIES

SECOND LAUNGUAGE(HINDI)

SUBJECT GRADES IN FIGURES

.GPA :

SUBJECT GRADE PERCENTAGEOF MARKS

.CGPA :

ENGLISH

TELUGU

HISTORY, CIVICS &GEOGRAPHY

MATHEMATICS

SCIENCE

COMPUTERAPPLICATIONS

SUBJECT GRADE GRADE POINT(G.P.)

.CGPA :

ENGLISH COMM.

HINDI COURSE - A

MATHEMATICS

SCIENCE

SOCIAL SCIENCE

IPE 1st Yr.JUN (Betterment)

IPE 2nd Yr. IPE 2nd Yr.Subject

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

EnglishSanskritMaths AMaths BPhysicsChemistryPhysics PracticalChemistry PracticalTotal Marks inFigures 470

BOARD OF INTERMEDIATE EDUCATION A.P. Regd. No.

470 1000 1000

in m m y y y y

Date of Birth :

Secondary School Certificate Indian Certificate of Secondary Education Central Board of Secondary Education

JUNMAR 2 0 1IPE 1st Yr.

MAR 2 0 1Max

Marks100100757560603030

d d m m y y y y

2 0 1

Documents

(Regd. An Ex-Officer Enterprise) JOBS INTER + JOBS X XXvizagdefenceacademy.com/pdf/VDA_Application.pdfFILL ALL COLUMNS IN BLOCK CAPITAL LETTERS 7.B Chest (after expansion) Cm 6. Weight