NEHRU SEVA SANGH Training Centre for Teachers (OR034) Diploma in Special Education Visual Impairment (DSE-VI) For Admission, Contact:- Mr. Pradeep Kum

प्रतिलिपि

1

2

3

4

5

6

7 NEHRU SEVA SANGH Training Centre for Teachers (OR034) Diploma in Special Education Visual Impairment (DSE-VI) For Admission, Contact:- Mr. Pradeep Kumar Das Admission Co-ordinator ID- / Mobile No / Institution Contact Details:- Ms. Sarojini Dash Secretary, Nehru Seva Sangh, Banpur, Khordha, Odisha ID- / Ph /158 & Mo. No

8

9

10

11 ଭ ରତ ସରକ ରଙ କ ଅଧ ନ ଏକ ବ ଧ ନ କ ନ କ ଶ- ଭ ରତ ୟ ପ ନ ବ ସ ପର ଷଦ (RCI) ଅନ ବ ଦନ ପ ର ପ ତ, ବନବ ର ବସ ସ ଘ ସ ଯ ଗ ନ ଅନ ତ ସ ଵତନ ତ ର ଶ କ ଷ (ଦ ଷ ଟ - ଧ ତ)ବର ଡ ବପଲ ଶ କ ଷକଙ କ ପ ଇ ପ ରଶ କ ଷଣ ବକନ ଦ ର Training Centre for Teachers (OR034) [Diploma in Special Education-Visual Impairment (DSE_VI)] ଣପ ର, ବ ର ଦ ବ, , ଓଡ ଶ ବ ନ /158, ଇ-ବ ଲ : nehrusevasangh@gmail.com, Website: ଶ କ ଷ ଷବ ପ ଇ ଏ.ଆଇ.ଓ.ଏ.ଟ. ପଞ ଜ କରଣ, ପର କ ଷ ଓ ନ ବ ସ ବ ଶଷ ରଣ ଭ ରତ ୟ ସ ଵତନ ତ ର ଶ କ ଷ ଏ ଦ ୟ ଙ ଗତ ବକ ଷତ ରବର ସ ସ ତଙ କ ପ ଇ ନ ର ଯ କ ତ ଭ ତ ତ କ ବପଶ ଗ ତ ପ ଠୟକ ର ପ ନ ବ ସ ସ ଵତନ ତ ର ଶ କ ଷ ବର ଧ ୟ ବର କୟ ର ୟର ଗ ଠନ ସ ବର ଯ ଗ : ଦ ୟ ଙ ଗଜନ ଶ ଶ ନଙ କ ଶ କ ଷ ଦ ନ ନ ବ ସ ଵତନ ତ ର ଶ କ ଷକ ନଙ କ ପ ରଶ କ ଷ ତ କର ପ ଇ RCI ଦ ଵ ର ଅନ ବ ଦ ତ ପର ଷଦ ବନବ ର ବସ ସ ଘ ଦ ଵ ର ପର ଚ ଳ ତ ଶ କ ଷକଙ କ ପ ଇ ପ ରଶ କ ଷଣ ବକନ ଦ ର (NSS-TCT)ବର ସ ଵତନ ତ ର ଶ କ ଷ ବର ଡ ବପଲ (DSE-VI) ସ ତର ୟ(C.T. ସ ସ କକ ଷ) ପ ଠୟକ ର ବର ଶ କ ଷ ଷବ ପ ଇ ପ ରବ ଶ ନ ବ ବର ଯ ଗ ୟ (RCI) DIPLOMA ଦ ଇ ଷ ୟ C T ସ ପ ର ଥ ବ ନଙ କ ଠ ର ଦର ସ ତ ଆ ଵ ନ କର ର ଯ ଉଅଛ ଉପବର କ ତ ଡ ବପଲ ସ ତର ୟ ପ ଠୟକ ର ବର ପ ରବ ଶ ବକ ଳ ଦ ଵ ର ଅଖ ଳ ଭ ରତ ୟ ଅନ ଇନ ପ ରବ ଶ କ ପର କ ଷ (ଏଆଇଓଏଟ )ର ପଞ ଜ କରଣ ନ ବ ଅନ ଇନ ଣ ବଡ ସ ୟ ସ ର ଦ ପବର 15 ଅବପ ର, 2019 ପର ଯବୟ ବ ର ଜ ଞ ପ ତ ପର କ ଷ ଶ ଳ କ: ସ ଧ ରଣ ଓ ପଛ ଆ ଗ ବ ଆଶ ୟ ପ ର ଥ ବ ଙ କ ପ ଇ ଟ.500/- ତଥ ୟ ଳ : ଏସ.ଟ., ଏସ.ସ. ଓ ଭ ନ ନକ ଷ ପ ର ଥ ବ ନଙ କ ପ ଇ ଟ.400/- ଏ ର ଷ ପ ଇ ସ କକ ଷ ଳ ଳକ ଭ ତ ତ କର କର ର ଯ ଆଶ ୟ ପ ର ଥ ବ ଙ କ ବକ ରଡ ଟ କ ଡବ,/ ବଡ ଟ କ ଡବ Merit ଅନ ର ଯ ୟ ଅନ ଇନ ୟ ଙ କ ଙ ଗ ଧ ୟ ବର Training ବଦୟ ବପ ଠ କର ର ଯ ସ ବର ଯ ଗ ବର ଯ ଗ ୟତ : ବକ ଣସ ନୟତ ପ ର ପ ତ ବକନ ଦ ର ୟ/ର ଜୟ ଶ କ ଷ ବ ଡବର ସ ବନ ନ 50% ନ ଵର ସ ତ +2(ଦ ଵ ଦଶ) ଅ ଯ ର ସ ଯ ଗ ତତ ତ ୟ ପର କ ଷ ବର ଉତ ତ ର ଣ ବ ବ ଇଥ ପ ର ଥ ବ ଆବ ଦନ କର ପ ର ବ ଅ ତ ର ଣ ବ ବ ଇଥ ପ ର ଥ ବ ଏଯ ର ଚଳ ତ ଷବ +2(ଦ ଵ ଦଶ) ପର କ ଷ ବର ଧ ୟ ଏ ପର କ ଷ ପ ଇ ଆବ ଦନ କର ପ ର ବ, କ ବସ +2(ଦ ଵ ଦଶ) ପର କ ଷ ବର ସ ବନ ନ 50% ନ ଵର ପ ର ପ ତ କର ନ ତ ଆ ଶୟକ ଡ ବପଲ ସ ତର ପ ଠୟକ ର ବର ପ ରବ ଶ ଗ ଅନ ସ ଚତ AIOAT ଜ ତ (sc)/ ଅନ ସ ଚତ ଜନଜ ତ (ST) / ଅନୟ ନୟ ପଛ ଆ ଗ ବ(OBC)/ ଭ ନ ନକ ଷ (PWD) ଗ ବର ପ ରଶ କ ଷଣ ଥ ବ ଙ କ ପ ଇ ପ ଇ 10+2(ଦ ଵ ଦଶ) ସ ତରବର ନ ଵରବର ବକ ଳ ର ଜୟ/ବକନ ଦ ର ସରକ ରଙ କ ନଦଡ ଅନ ର ଯ ୟ ଗ ବ ପଞ ଜ କରଣ ୪୦,୦୦୦/40 Hostel ଅଖ ଳ ଭ ରତ ୟ ଅନ ଇନ ପ ରବ ଶ କ ପର କ ଷ (ଏଆଇଓଏଟ ) ସ ଵନ ଧବର ସ ବ ଶଷ ରଣ ନ ବ କର ନ ଅନ ତ ଷବକ Course Fee ସ ଧ ଅଛ ଭ ରତ ୟ ପ ନ ବ ସ ପର ଷଦର ବଣ ସ ଇଟ ପର ଦଶବନ କର ଏ.ଆଇ.ଓ.ଏ.ଟ. ପଞ ଜ କରଣ, ପର କ ଷ ଓ ନ ବ କ ର ଯବୟସ ଚ : ସ ବ ଶଷ କ ର ଯବୟ ଧ ର ଅନ - ଇନ ପଞ ଜ କରଣ ପର କ ଷ ପ ଇ ଆଡ - ଟ କ ଡବ ପ ରଦ ନ ପ ରଥ ଧ ର ଯବୟ ତ ର /ଅ ଧ 1ବ ୟ ର ର 15 ର ଚ ବ, 2019 ସ ୟ ସ ର ଦ ପବର ଧ ର ଯବୟ ଅ ଧ 16 ର ଚ ବ ର 15 ଅବପ ର ର ଚ ବ, 2019 ଠ ର 26 ଅବପ ର, 2019 ଠ ର ଅନ - ଇନ ପର କ ଷ (ଅନ- ଇନ ଉଇବଡ ) 21 ଅବପ ର, ଇ, 2019 ପର କ ଷ 24 ଅବପ ର, ଇ, 2019 ବ ର ଟ ଅନ ର ଯ ୟ ପ ରଥ ର ଉଡ ଆଡ - ଶନ 30 ଅବପ ର ର 6 ଇ, ଇ ର 24 ଇ, 2019 ବ ର ଟ ଅନ ର ଯ ୟ ଦ ଵ ତ ୟ ର ଉଡ ଆଡ - ଶନ 8 ଇ ର 15 ଇ, ଇ ର 03 ଜ ନ, 2019 ବ ର ଟ ଅନ ର ଯ ୟ ବଶଷ ର ଉଡ ଆଡ - ଶନ 17 ଇ ର 25 ଇ, ଜ ନ ର 12 ଜ ନ, 2019 ଳ ଳ ବଘ ଷଣ ସ ଥ ନ ୟ +2 (ଦ ଵ ଦଶ) ଓ ତଦ ର ଦ ବ ବର ଯ ଗ ୟତ ସମ ପର ଣ ବ ର ଯ କ-ର ଯ ତ ନଙ କ ଉପବର କ ତ ପ ରକ ର ୟ ଓ ଧ ର ଯବୟ ସ ୟ ସ (15 ଅବପ ର ) ଧ ୟବର ପଞ ଜ କରଣ ତଥ ପର କ ଷ ବର ସ ଳତ ପ ର ପ ତ କର ପ ରଶ କ ଷଣ [ Training ] ର ସ ବର ଯ ଗ ବନ କ ଅନ ବର ଧ (. ଦ ର.:- ସ ଥ ନ ୟ ସ ସ ତ (Gen, OBC, ST, SC & PWDs) ଗ ବର ଆଶ ୟ ପ ର ଥ ବ -ପ ର ଥ ନ ବନ ପ ରଶ କ ଷଣର ସ ବର ଯ ଗ ବନଇ ପ ର ବ ) ବର ଯ ଗ ବର ଯ ଗ : ଆଡ - ଶନ ବକ ଅଡ ବନଟର ବ & ସମ ପ ଦ କ ବନବ ର ବସ ସ ଘ, ଣପ ର

12 NEHRU SEVA SANGH Po. Banpur, Dist. Khordha, Pin , Odisha (India) Ph / (Fax) nehrusevasangh@gmail.com & nssdsetctbanpur.2018@gmail.com Website: DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (DSE-VI) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) ADMISSION PROSPECTUS FOR ACADEMIC SESSION LAST DATE FOR RECEIPT/APPLY OF COMPLETED ONLINE APPLICATION FORM TO RCI ADMISSION PORTAL, IS (NB.: THE DATE OF APPLICATION MAY BE EXTENDED BY RCI IF NESSESARY) EXAM FEES: FOR GENERAL/OBC: Rs. 500/- & FOR SC/ST/PH CATEGORY: Rs. 400/- Rs. 500/- (Rupees Five Hundred) only for General and OBC candidates, Rs. 400/- (Rupees Four Hundred) for SC, ST and PwD candidates should be remitted through payment gateway using a Credit Card or a Debit Card issued by Banks in India or through online banking. For complete details in respect of Fees and All India Online Aptitude Test (AIOAT- 2019), Please visit RCI website:

13 Nehru Seva Sangh Po. Banpur, Dist. Khordha, Pin , Odisha (India) 1. A) INTRODUCTION NEHRU SEVA SANGH (NSS), a premier philanthropic institution was established in 1946 at Banpur in the District of Khordha by late lamented Santh Harihar Ram ji while India was in the threshold of her independence to render philanthropic social service to the poor and downtrodden people of Odisha suffering from utter poverty, illiteracy and ignorance. It serves as a beacon light for the people of Odisha with the prime/main objectives as under: AIMS AND OBJECTS: a) The promotion of education in all its aspects including imparting of education through night schools, b) c) d) e) f) g) h) 1.B) maintenance of libraries, both stationary and moving and publication of books and magazines. To establish and maintain hospitals and thus provide treatment of the sufferers and also provide free medical attendance to the needy. To help orphans, backward people, adivasies, the handicapped, the juvenile criminals and such other destitute people as may require such and develop them to useful citizens. To organise and train volunteer corps for social service such as rendering help at the time of festivals, havocs and other suitable occasions as well as during fires, and specially to work among Adivasies and Backward classes for the amelioration of their condition.. To maintain and run institutions where training in cottage industries and other similar products could be given. To work for improvement of labour and establish Labour Welfare Centres. To take up all such activities as are not contrary to the purpose of the organisation and the provisions of the Societies Registration Act, 1860, and approved by the Executive Committee of the Sangh, from time to time. NEHRU SEVA SANGH DISABLED WELFARE ACTIVITIES: NSS stated its Disabled Welfare Activities in 1978.The Person with Disabilities Act / RPwD Act, 2016 ensures equal opportunities, protection of Rights and full particiapation of the PwDs. They need proper care, attention and suitable Reabilitation in the society. In a family a disabled person is looked upon as a burden. It is our collective responsibility to look after their proper education, training and rehabilitation. Realising this as priority area of work, NSS under taken multifarious activities in the field of disability (DIVYANGAJAN) as per the following: The Sangh runs following one long-term course (Two-year duration) Approved by RCI, New Delhi: * Diploma in Education (Special Education) (VI) (D. Ed. S.E. (VI) The Sangh conducts short/long term training programmes/ Seminars every year. There are two special schools for children with Visual Impairment and Hearing & Speech Impairment. Services in the areas of special education, vocational training, community/ home based support and early intervention are provided by the Sangh. The centre conducts awareness camps and screening camps as a part of its extension and outreach activity. The centre also provides technical support to NGOs working in the field of Disabilities.

14 1.C) GENERAL OBJECTIVES OF THE COURSE The Diploma course in Special Education aims to develop professionals for special education within a broad frame work of education in the current millennium. The course will enable pre-service teachers to acquire knowledge, develop, competencies and practice skills to impart education to children with special needs. The general objective of the course is to prepare Special teachers at pre- primary (Nursery, Kindergarten etc) and primary (I to VIII) levels to serve in the following setting: 2.A) Special Schools Inclusive setup / Schools Home based Programmes / Itinerant model programmes KNOWLEDGE RELATED OBJECTIVES To build adequate knowledge in the following areas: 1) 2) 3) 4) 5) 6) 2.B) Various aspects of disability, its impact and management. Key aspects of education like goals, function, technology and emerging trends Educational needs of the children with disability and their management Details of planning and executing curricular and co-curricular activities. Methods and techniques of teaching school subjects. Various areas of child development and the relevant mental processes. SKILL RELATED OBJECTIVE To develop skills and competencies in the following areas: 1) 2) 3) 4) 5) 6) 7) 2.C) Personal, professional and social competencies and skills required in teachers. Subject teaching as per requirement Development and adaptation of instructional materials Evaluation of the students, teacher and the educational programme Planning and executing lessons (Individualized group) Classroom management techniques. Individual and group parent interaction. ATTITUDE RELATED OBJECTIVES To develop desirable attitudes towards following issues: 1) Role and need of education in the modern world 2) Teaching profession and role of teachers in changing society 3) Guiding children and solving their academic / behaviour problems. 2.D) General Framework of the Course The diploma course consists of 4 core papers and additional papers pertaining to specific disability areas. Though the number of papers pertaining to disability specialization may vary, the core papers are common across the specialization areas. Each paper will have a total of 90 hours for curriculum transaction. (Revisit again after revision of the syllabus).

15 3. JOB OPPORTUNITIES On completion of the DSE course, trainees can work as Special Teachers at preprimary (Nursery, Kindergarten etc) and primary (I to V primary and VI to VIII Upper primary) levels to serve in the following setting: Special Schools Integrated / Inclusive setup Itinerant programme and CBR Programmes 4. ELIGIBILITY a) Candidates who have passed or Higher Secondary examination or equivalent there to, with minimum 50% marks and 45% marks for candidates belong to SC/ST from any recognized Board are eligible for the course. b) CANDIDATES QUALIFIED ALL INDIA ONLINE APTTITUDE TEST (AIOAT) CONDUCTED BY RCI, NEW DELHI. Weblink: RCI s latest admission norms will be followed during the time of admission. 5.A) ADMISSION AND SELECTION CRITERIA Online Admission to all Diploma Level Courses of RCI will be made through AIOAT conducted by National Board of Examination in Rehabilitation (NBER). National Board of Examination in Rehabilitation an adjunct body of the Rehabilitation Council of India has been conducted the AIOAT for admission to Diploma level Courses in Special Education. AIOAT2019 will be conducted during April / May, 2019 at different exam centres situated in various parts of the country. Based on the AIOAT result, the National Merit List will be prepared by the Council, which will be available on the Council's website. Accordingly, those who will be qualified the AIOAT The following criteria have been prescribed by the Council for online admission to Diploma level Courses in respective disability areas for the academic year All seats to be filled only from the All India Qualifying Merit List of candidates who have scored 38 marks and above in aggregate in AIOAT-2019 irrespective of their category as per total seats of Diploma Level Courses.

16 I. Admission to this institute will be done on the basis of the All India Qualifying Merit List of candidates (AIOAT- 2019) who have opted this institute for admission. II. The qualified candidate can take admission in only one institute. Once admission is completed at any one of the institutions opted by the candidate in Online Admission Portal, he /she will not be able to surrender & take admission at any other Institute. III. Candidates should produce the following documents to Centre Coordinator for admission to diploma level Courses as opted by the candidates: Application Form Admit Card of AIOAT Copy of score card of AIOAT th, 10+2 Mark-Sheets and Board certificates in original. Leaving Certificate at last appearance of study. Passport size latest colored photograph and Copy of Aadhar Card (student & parents). Candidates belongs to the reserved category shall produce Original Caste Certificate/PwD Certificate issued by the appropriate authority of the State Govt.. V. Requisite Admission fee to be paid for admission to confirm the seat. VI. Candidates who could not take admission in 1st round of admission due to any reason, may have opportunity to take admission in the subsequent rounds, subject to the availability of vacant seats at the centre in the same diploma level courses opted during filling AIOAT, 2019 Application Form. VII. Admission of the reserved category of candidates belongs to OBC, SC, ST and PH will be made in accordance with the State Govt. Policy. VIII. Candidates will not be allowed to change the option of course as mentioned in the AIOAT Application Form without consent of RCI, New Delhi. 2. All seats of the total intake as approved by the Council will be filled up from the All India Qualifying Merit List of AIOAT on or before the last date as prescribed by the Council. 3. During first round of admission, first preference will be given to those candidates who has opted the institution in their order of choice.

17 5. B) No candidate is allowed to change the course of study once admitted and if he/she is still desirous to join any course within the institute, the fee/deposits remitted to the institute shall be forfeited. 6. JOINING AND SUBMISSION OF CERTIFICATES Selected candidates should join the course by the stipulated date. At the time of joining the course, the selected candidates will have to produce. (a) Undertaking to the effect that the admitted candidates will not discontinue the course, (b) Medical certificate of fitness from a Civil Surgeon / any Govt. hospital declaring the state of health and (c) others training related undertakings i.e. (d) Training placement & (e) prohibiting ragging, etc. 7. NUMBER OF SEATS: As per RCI approval 25 seats only. 8. DURATION The duration of the Training course will be 2(two) years, which will contain 220 working days consisting of 1320 hours each year thus having a total of 2640 hours with a 6(six) hours of instruction per day and sometimes can be more if required for theory and practicum. 9. MEDIUM OF INSTRUCTION Delivery of lectures will be in English, Hindi & regional language (Odia) And the candidates will also be allowed to write the final exam in English, Hindi & Odia. 10. ATTENDANCE Minimum attendance of 80% is essential to be eligible for appearing for the examination. 10% attendance may be considered in case of illness on production of proper medical certificate. 100% of the practical work and assignments should be completed and certified by the respective faculty prior to the examination. However, the final decision of allowing for examination will be taken by the competent authority. Any shortage of attendance will have to be made up before final examination by the student concerned and the institute does not take responsibility whatsoever in arranging theory and practical classes. The applications of these candidates with shortage of attendance will not be considered for issue of hall ticket to appear in examinations. The institute reserves the right to cancel the admission if the candidate admitted is found to be habitually absent or is not putting up the required attendance or is not making significant improvement in studies or not taking interest in pursuing the course of study. The guidelines pertaining to the examination procedures prescribed by the Rehabilitation Council of India shall be adopted.

18 11. EXAMINATION There will be semester pattern examinations at the end of every two quarter of each academic year. The trainees will appear 4th semester examination at the end of the FINAL year. 12. AWARD OF DIPLOMA Based on the performance during the course and on the annual examination, the successful candidates will be awarded Diploma in Special Education (DSE-VI. Minimum marks of passing examinations will be 40% in each theory paper (internal and external separately) and practical paper will be 50% (internal and external separately). Candidates scoring 75% and above will be awarded the Diploma with Distinction. 13. FEES & OTHER DIPOSITS Sl. No 1 Course Fees Uniform - 1 pair 1, P.A. 3 Others: Sports / Recreation Fees 1, P.A. Library Fees 2, P.A. Exposure Visit/ Study Tour 2, P.A. 5 Amount (In Rs) 30, P.A. Admission & Tuition Fees 2 4 Deposits Amount (In Rs) Caution Deposit (Refundable) Library Deposit (Refundable) 2, , Details of Extra/ Other Fees 5 Examination Fees As fixed by RCI/NBER For each semester examination time to time Hostel Charges (For Shared Hostel 6 6, P.A. Accommodation) Food & Other Expenses 2, P.M. (Approx) Hostel Deposit (Refundable) 1, The tuition and examination fee and other expenses will be charged from the students as and when revised by NSS authority and Rehabilitation Council of India (RCI), New Delhi. Deposits will be refundable after completion of the course to only those candidates who complete the entire course. In addition to the above quoted fees, any additional statutory fees required to be paid to respective University/Board will be collected from the students at a later stage as per statutory requirements. The candidates once admitted in the course will not be allowed to leave under any circumstances. If the candidate desires to leave the course by any reason, the total fees and deposits paid by the candidates will be forfeited. The deposits paid will be returned to candidates only on successful competition of the course of the study and after final examination.

19 Original certificates deposited will not be released during the course and students are advised to keep sufficient number of photo copies before submission of original certificates to office at the time of admission HOSTEL ACCOMODATION Shared hostel accommodation to outstation & Disabled candidates will be provided on nominal charge at NSS or outside campus subject to availability on first-come-first-served basis. The trainees will have to bear the expenses on food & other consumable / recurring items in the hostel OR by joining a student s run mess DISCIPLINE: The candidates admitted should abide with discipline within the prescribed administrative regulations and also avail the hostel accommodation as provided. The candidates are expected to maintain decorum, decency and discipline throughout their pursuance of the course with the staff, faculty, co-students and other supporting staff. The hostellers should follow the prescribed rules and regulations. Any infringement of violence shall result in removal of the student from the hostel for the period as decided by the management of the institute. Ragging is a crime prohibited under law. Anyone found indulging in the unethical act of ragging would be dealt with due legal procedures. Programme Coordinator, Nehru Seva Sangh, Banpur, Pin , Dist.- Khordha (Odisha).

20 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) UNDERTAKING BY THE CANDIDATE / STUDENT (TRAINEE) 1. I, S/o, D/o, have carefully read and fully understood the following: I hereby undertake that: 2. I once admitted in the course will not leave the same under any circumstances. If I desire to leave the course by any reason, the total fees and deposits paid by me will be forfeited. 3. I will claim my deposits for return only on successful competition of the course of the study and after final examination. Signed this day of (year) _ (month) of Date: Signature of the Student/Trainee Place: Name Address: :

21 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) HEALTH STATUS DECLARATION I.. hereby declare that I am / am not suffering with infectious diseases / chronic health problems / psychiatric problems / having pregnancy. In the event of my above health problems I am enclosing Medical Certificate issued authorized Medical Practitioner for my above health problems. I agree with the decision of NSS TCT authorities that my admission is liable to cancelled if I am unable to complete the course (DSE-VI) requirement as prescribed norms of attendance or completion of assignments. Date: Place: SIGNATURE OF APPLICANT Ref. No. Address:

22 DECLARATION (FOR SC/ST/OBC/PH STUDENTS) I Mr/Ms. S/o,D/o.Shri Aged years R/o do hereby undertake that I am not drawing any Scholarship under the scheme for SC/ ST/ OBC/ PH from any Government Authority for my Studies for the year The Annual Income of my Family is Rs. (Rupees ) per Annum as per the certificate of Tahasildar / Local Authority Attached. Signature of the Parent Date: Place: Witness: 1) 2) Signature of the Candidate

23 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) UNDERTAKING BY THE CANDIDATE / STUDENT (TRAINEE) 1. I, S/o. D/o. Mr/Mrs/Ms have carefully read and fully understood the law prohibiting ragging and the directions of the Supreme Court and Central / State Government in this regard. 2. I hereby undertake that: I will not indulge in any behaviour or act that may come under the definition of ragging. I will not participate in or bet or propagate ragging in any form, I will not hurt anyone physically or psychologically or cause any other harm. 3. I hereby agree that if found guilty of any aspect of ragging, I may be punished as per the provisions of the regulations mentioned above and / or as per the law in force. 4. I hereby affirm that I have not been expelled or debarred from admission by any Institution earlier. Signed this day of (month) of Signature Date: (year)

24 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) UNDERTAKING BY PARENT / GUARDIAN 1. I, F/o. M/o. G/o. have carefully understood the law prohibiting ragging and the directions of the Supreme Court and the Central / State Government in this regard on curbing the Menace Of Ragging in Educational Institutions. 2. I assure you that my son/ daughter/ word will not indulge in any act of ragging. 3. I hereby agree that if he / she is found guilty of any aspect of ragging, he / she may be punished as per the provisions of the regulations mentioned above and / or as per the law in force. Signed this day of (month) of Date: Signature Place: Name Address: : (year)

25 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) UNDERTAKING BY THE CANDIDATE / STUDENT (TRAINEE) 1. I, S/o, D/o, have carefully read and fully understood the following: 2. I hereby undertake that: I do not have any objection to be placed in various institutes in the field of disability rehabilitation in India, as part of the course curriculum. Signed this day of (month) of (year) Date: Signature of the Student/Trainee Place: Name Address: :

26 NEHRU SEVA SANGH TRAINING CENTRE FOR TEACHERS DIPLOMA IN SPECIAL EDUCATION (VISUAL IMPAIREMENT) (Two Academic Year Diploma Course Recognized by RCI, New Delhi) Po. Banpur, Dist. Khordha, Pin , Odisha (India) UNDERTAKING BY PARENT / GUARDIAN 1. I, F/o, M/o, G/o carefully read and fully understood the following: 2. I hereby assure that: _ have I do not have any objection that my son / daughter to be placed in various Institutes in the field of disability rehabilitation in India, as part of the course curriculum. I do not have any objection that my son/daughter will also be placed in community work settings in the field of disability rehabilitation anywhere in India during the period of the course. Signed this day of (month) of Date: Signature Place: Name Address: : (year)

27

28

29

30

31