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Price: INR 2000/- Application Registration No.

Consortium of Self Financed Medical and Dental Colleges of Gujarat State

APPLICATION FORM -cum-

RULES & REGULATIONS (NRI Quota Seats) 2016 – 17

M.B.B.S. Course at: Sr.

No.

College name No. Seat

Medical Colleges

1 GMERS Medical College, Sola, Ahmedabad 23

2 GMERS Medical College, Gotri, Vadodara 22

3 GMERS Medical College, Gandhinagar 23

4 GMERS Medical College, Dharpur-Patan 22

5 GMERS Medical College, Valsad 23

6 GMERS Medical College, Himmatnagar 22

7 GMERS Medical College, Junagadh 23

8 NHL Municipal Medical College, Ahmedabad 38

9 AMC MET Medical College, Ahmedabad 22

10 GCS Medical College, Ahmedabad 22

11 CU Shah Medical College, Surendranagar 15

12 Gujarat Adani Institute of Medical Sciences 23

13 Surat Municipal Institute of Medical Education & Research, Surat

23

Dental College

1 AMC Dental College, Ahmedabad 15

2 Siddhpur Dental College, Siddhpur 15

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R E C E I P T

Received from Mr. /Miss

(For candidate to write)

An application form for admission to FIRST M.B.B.S. Course on NRI seat along with

Application and Processing Fees of Rs. 8000/-by D.D. No.___________________ in

favour of “Consortium of SFI Medical and Dental Colleges, Gujarat State” Payable at

Ahmedabad Drawn on Bank and Branch _______________________________ Date: __________________

LAST DATE OF RECEIVING APPLICATION: 8th September, 2016

For Office Use Only

Regd. No. Dated.

Receiver’s Signature Consortium of Self Financed Medical and Dental Colleges of Gujarat State ______________________________________ Tel. No. Office : +91 79 23240296

Fax : + 91 79 23240295

Email : deangmersmcg@gmail.com

Website:- www.medadmbjmc.in, www.gmersmchgandhinagar.com, www.gmers.gujarat.gov.in, www.sfimdgujarat.com

For Office Use ONLY

Name: _______________________________ NEET Roll No.__________________

NEET Overall Rank:_______________

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IMPORTANT INSTRUCTIONS

1. This application form is common for admission on NRI Seats at the following

Medical Colleges:

i. GMERS Medical College, Sola, Ahmedabad ii. GMERS Medical College, Gotri, Vadodara

iii. GMERS Medical College, Gandhinagar iv. GMERS Medical College, Dharpur-Patan v. GMERS Medical College, Valsad

vi. GMERS Medical College, Himmatnagar vii. GMERS Medical College, Junagadh

viii. NHL Municipal Medical College, Ahmedabad ix. AMC MET Medical College, Ahmedabad x. GCS Medical College, Ahmedabad

xi. CU Shah Medical College, Surendranagar xii. Gujarat Adani Institute of Medical Sciences

xiii. Surat Municipal Institute of Medical Education & Research, Surat This application form is also valid for admission on NRI Seats at the following Dental College: i. AMC Dental College, Ahmedabad

ii. Siddhpur Dental College, Siddhpur

2. Students should carefully read the rules for admission before submitting the

application form. In the event of anything stated therein being found factually

incorrect, the admission will be liable to be cancelled and concerned candidate

will be liable to face legal action.

3. A candidate seeking admission to the M.B.B.S. / B.D.S. Courses on NRI seats must

submit his/her application in writing in the prescribed form which may be

downloaded from www.medadmbjmc.in, www.gmersmchgandhinagar.com,

www.sfimdgujarat.com and www.gmers.gujarat.gov.in and submit with

Rs.2000/- as Form fees plus Rs. 6,000/- as Processing fees thus total Rs. 8000/- by

Demand Draft. The form duly filled and signed, together with all necessary

documents, a self-addressed envelope and DD is to be submitted personally during

office hours at Office of the Dean, GMERS Medical College, Gandhinagar on or

before the prescribed last date, i.e. 8th September, 2016 which is notified in the

newspaper. Incomplete application will be rejected. The payment shall be made by

DD in favor of “Consortium of SFI Medical and Dental Colleges, Gujarat State”

payable at Ahmedabad.

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4. Students joining Medical / Dental College will be awarded degree from concerned University to which the college is affiliated.

5. No application for admission will be considered unless it is accompanied by

notarized copies of the certificates and all necessary documents.

6. Any change in any of the documents or in the examination marks after submission

of the application should be promptly reported to the Office of the Dean, GMERS

Medical College, Gandhinagar with attested copy of the same. The candidate will be

responsible for consequences if he/she fails to do so.

7. Admission to NRI quota seats at Medical / Dental Colleges will be finalized on the basis of merit list as prescribed under the rules. Time table and venue for the personal interview will be announced on the website and will be intimated through E-mail ONLY. The students are advised to carefully note down the time and venue of their personal interview. The college will not be responsible if students loses his admission by remaining absent at the interview.

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RULES & REGULATIONS: The Rules for Admission to MBBS Course in NRI Quota Seats at Member Colleges are in accordance with the Rules decided by the Health and Family Welfare Department, Govt. of Gujarat. 1. DEFINITIONS:

(a) “NRI” means a Non-Resident Indian as defined under Income Tax Act.1961 read with Foreign Exchange Management Act, 1999. Accordingly following criteria will be used for determining the NRI status of the candidate / parent Non-resident Indian is “a person who is not resident in India”. The term NRI is defined under FEMA rules and regulations as ‘A person resident outside India who is either a citizen of India or is a person of Indian origin (PIO).’ Under the Foreign Exchange management (Deposit) Regulations, 2000, which deal with banking accounts in India by NRIs, the term PIO is defined as below: A Person of Indian Origin (PIO) is a citizen of any country other than Bangladesh or Pakistan, if he at any time held an Indian passport or he or either of his parents or any of his grandparents was a citizen of India by virtue of the Constitution of India or the Citizenship Act, 1955 or he is spouse of an Indian citizen or a person referred to in ‘a’ or ‘b’. Resident Outside India: Person resident outside India means a person who is not resident in India. Resident in India: Person Resident in India means: 1. Person Resident in India for more than 182 days during the course of preceding financial year but does not include: A) A person who has gone out of India or who stays outside India, in either case: (A.1) for or on taking up employment outside India; or (A.2) for carrying on outside India a business or vocation outside India; or (A.3) for any other purpose, in such circumstances as would indicate his intention to stay outside India for a uncertain period. B) A person who has come to or stay in India, in either case, otherwise than: (B.1) for or on taking up employment in India, or (B.2) for carrying on in India a business or vocation in India, or (B.3) for any other purpose, in such circumstances as would indicate his intention to stay in India for an uncertain period;

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2. Any person or body corporate registered or incorporated in India; 3. An Office, Branch or Agency in India owned or controlled by a person resident outside India; 4. An Office, Branch or Agency in India owned or controlled by a person resident in India.

(b) Person of Indian Origin: Person of Indian Origin" means a foreign citizen (not being a citizen of Pakistan, Bangladesh and other countries as may be specified by the Central Government from time to time) if,

_ he/she at any time held an Indian passport; or _ he/she or either of his/her parents or grand parents or great grand parents was a

citizen of India by virtue of the Constitution of India of the Citizenship Act,1955 (57 of 1955); or

_ he/she is a spouse of a citizen of India or a person of Indian origin covered under (i) or (ii) above.

2. ELIGIBILITY CRITERIA: As per notification by Health & Family welfare department, Government of

Gujarat, Gandhinagar.

a) (1) A candidate shall be Non-Resident Indian, or

(2) His/her parents or in absence of his/her parents, his/her legal guardian shall be Non-Resident India.

b) The candidate must have obtained minimum qualifying marks in 12th Standard as per regulatory Council.

c) The candidate should have appeared in NEET-UG-2016 examination and have been declared “Qualified”.

d) A candidate shall have completed 17 years of age on or before the 31st December of the Academic Year for which the admissions are being conducted.

e) “Provisional Eligibility Certificate” should be obtained from concerned University within one month of admission.

4. MERIT LIST:

Admission on the non-resident Indian seats shall be given by the management on the basis of inter-se merit based on: Overall Rank at the NEET-UG-2016 from among the candidates who have applied for admission against the Non-Resident Indian seats.

5. DOCUMENTS: Application will be considered only if it is accompanied by copies of the

following certificates, duly notarized.

(a) School Leaving Certificate or any other authorized document clearly showing date of birth.

(b) HSCE (or its equivalent examination) mark sheet, passing certificate and attempt

certificate.

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(c) NEET-UG-2016 Mark sheet (d) Document related to proof of place of origin (Citizenship/P.R. Card etc.)

(e) Undertaking in regards of fees from NRI Student / Parent for NRI/ NRI Children / NRI

Ward Category. (f) Passport (Notarized color Xerox copies of all pages of Passport) of NRI / NRI Children /

/Ward category which should include the period from 1-4-2015 to 31-3-2016. If the current passport does not include this period, copy of the previous passport is also to be submitted.

(g) Visa / Resident permit / OCI / PIO card as applicable (h) Address proof (Indian and foreign) (i) Self addressed envelope. (j) Transcript in case of student from foreign country.

6. The applicant shall have to produce the original certificates mentioned in 5a, 5b and 5c

and for all other documents, Notarized color copies to be submitted at the time of

submission of application. Originals of documents mentioned in 5d, 5e, 5f and 5g shall

have to be produced at the time of interview. If during scrutiny or any time thereafter any

discrepancy or incorrectness is noticed, the admission is liable to be cancelled forthwith.

The candidate could be expelled and criminal action would be initiated against him.

7. Tuition Fees:

Following is the Tuition Fee structure for different institutes granting admission through this application:

Sr. No. Name of Institute Annual Fee Medical Colleges

1-7 GMERS Medical Colleges at Sola-Ahmedabad, Gotri-Vadodara, Gandhinagar, Dharpur-Patan, Valsad, Himmatnagar and Junagadh

US $ 17,000 or equivalent in Foreign currency

8 NHL Municipal Medical College, Ahmedabad US $ 25,000 9 AMC MET Medical College, Ahmedabad US $ 25,000

10 GCS Medical College, Ahmedabad US$ 24,200

11 CU Shah Medical College, Surendranagar Rs. 9,00,000 per semester

12 Gujarat Adani Institute of Medical Sciences, Bhuj Rs. 19,00,000 or equivalent in foreign currency

13 Surat Municipal Institute of Medical Education & Research, Surat

1,05,000 US $ for whole course

Dental College:

1 AMC Dental College, Ahmedabad US $ 12,000

2 Siddhpur Dental College,Siddhpur US $ 10,000

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8. Payment of Fees: (A) For GMERS Medical Colleges:

(i) The tuition fees payable will be as follows:-

The fees shall be paid every six months (US $ 8,500 or equivalent in foreign

currency).

(ii) In addition, the student will pay enrollment fees to the University at the time of admission as prescribed by the University and will also pay before beginning of each term fees for students’ gymkhana as fixed by the Dean from time to time.

(iii) The tuition fees US $ 76,500 is for the prescribed duration of MBBS course i.e.

4½ years of the study of medical course and one year of internship. If this

period is prolonged beyond 4½ years for reasons such as failures or drop at the

examination, inadequate attendance etc., the student will have to pay

additional fees as under:

(a) Failed in one subject: US $ 708/- (b) Failed in two subjects: US $ 1417/- (c) Failed in three subjects: US $ 2125/-

(iv) The tuition fees should be paid through a crossed D.D. in foreign currency drawn in favor of “NRI Admission GMERS” payable at Gandhinagar OR by wire transfer or electronic transfer.

(v) All the students who are admitted under NRI seats quota will have to submit an

undertaking for the payment of fees in the format prescribed by the institute and submit it along with the application form.

(vi) The selected student will pay the tuition fee for the full academic year if he/she

leaves course incomplete and join the other college after final counseling.

(vii) The Selected student will pay Institutional Tuition Fee as prescribed from time

to time per year. No fees / charges will be refunded if a student leaves the course

midway for any reason whatsoever or is expelled from the college for any reason

whatsoever or is prohibited by the university to pursue his studies further for any

reason.

(vii) Fees, once paid will not be refunded except Candidate who was admitted

provisionally is declared not eligible for admission by the University afterwards in which case 90% of the tuition fees will be refunded.

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(B) For Other Colleges: As decided by respective Managements.

AMC MET Colleges: The selected student will pay the total amount institutional fee (all years) if he/she leaves course incomplete for any reason after 30-09-2016.

9. Residence in the college hostel will be offered to the students as available. The allotment,

decided on the basis of merit/requirements, will be at the discretion of the Dean / Principal. Admission to the college does not guarantee hostel admission.

10. The hostel fees will be charged at rate fixed by the respective Management from time to

time and will be paid by the student before the beginning of each term. Any other fee is to be paid by student, as decided by college authorities at par with all students.

11. So long as the father of the student is alive, no other person will be ordinarily accepted as

his guardian.

12. Chairman, GMERS reserves the right to insert any new rule or to edit / modify / delete any

rule to meet the exigencies of situation at any time. .

13. The college follows the curriculum and study pattern prescribed by the Medical council of India, as per its present guidelines the academic terms are as follows: (a) First Term : August to January

(b) Second Term : February to July. 14. For further information or clarification, contact:

Tele:- +91-79-23240296 Fax: +91-79-23240295 Web:www.medadmbjmc.in,www.gmers.gujarat.gov.in, www.gmersmchgandhinagar.com, www.sfimdgujarat.com

15. Interpretation: In implementation of the provisions of these rules, if any difficulty or question arises as to the interpretation of any provision, decision of the Chairman, Gujarat Medical Education and Research Society shall be final.

16. The Jurisdiction of any dispute will be at Ahmedabad.

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Application Form M.B.B.S. /B.D.S. COURSE ON

NRI SEATS for Academic Year 2016-2017 Course Applied For (Please √ mark): M.B.B.S.

B.D.S. IMPORTANT: (1) Students should carefully read the rules for admission before submitting the application form. The application must be accompanied with Form Fees of Rs.2,000/- plus Processing Fees of Rs. 6,000/- thus total Rs. 8000/- by Demand Draft payable to “Consortium of SFI Medical and Dental Colleges, Gujarat State” payable at Ahmedabad. (2) Every entry in the form must be completed in detail. Incomplete applications are liable to be rejected. (3) No application for admission will be considered unless it is accompanied by attested copies of the documents mentioned in Rule No. 5. (4) Students should carefully read the rules for admission before submitting the application

form. In the event of anything stated therein being found factually incorrect, the admission will be liable to be cancelled.

A: APPLICANT’S DETAILS

1. Full Name: (Surname) (First Name) (Middle Name)

2. Father’s/Husband/

Guardian Name: (Surname) (First Name) (Middle Name)

______________________________________________ ______________________________________________

(c) Permanent Address: ______________________________________________ (Parents) ______________________________________________ 4. Present Address: _________________________________________________

(Applicant) _________________________________________________ _________________________________________________ _________________________________________________

Photo

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5.

Permanent Address: _________________________________________________

[if different from (4)] _________________________________________________

6. Telephone No & Area Code: (Mobile) : {____________} ____________________________

{Residence}: {____________}____________________________

{Office} : {____________}____________________________

{FAX} : {____________}____________________________

{E-Mail} : _________________________________________

(Mandatory) (Local Contact Phone No.) _______________________________

(Mobile) ___________________________________________ 7. Sex : Male / Female

8. Religion : __________________________

9. (a) Date of Birth : _________ ___________ __________ (Date) (Month) (Year)

(b) Age in completed year: ___________________________

(as on 31st

December, 2016)

10. Nationality: ___________________________

11. (a) Place of Birth (a) Country : ____________________

(b) State : ____________________

(c) District : ____________________

(d) City/Town/Village : _____________________

(b) If the place of birth is outside India, give following details:

(a) Present Nationality : ____________________

(b) Country of your present passport: _______________

(c) Passport Valid up to : _____________________

(d) Passport Number : ____________________

(e) Issued By : __________________________

12. Details of H.S.C. Examination (Std.XII) or its equivalent passed by student:

(a) Name of Examination :(a) __________________________________________

(b) Name of Board :(b) __________________________________________

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(c) Name of School :(c) __________________________________________

(d) Address of School :(d) __________________________________________

(e) Month & Year of Passing :(e) _________________________________________

(f) Examination Seat No. :(f) __________________________________________

(g) Marks obtained :(g) __________________________________________

(h) Number of attempts :(h) __________________________________________

13. Marks obtained at H.S.C.E. or Equivalent Examination:

SUBJECT

THEORY MARKS PRACTICAL MARKS

% Marks: (up to 4 digits)

MAXIMUM OBTAINED MAXIMUM OBTAINED

1. Chemistry

2. Physics

3. Biology

4. Total of 1 to 3

5. English ------

14. Marks obtained and Rank at NEET-UG-2016 Examination:

SUBJECT

MARKS

MAXIMUM OBTAINED

1. Chemistry 180

2. Physics 180

3. Biology 360

4. Total of 1 to 3 720

NEET Roll No.

NEET All India Rank – Overall

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15. No. of days spent abroad in the last financial year i.e. 1stApril 2015 to 31stMarch 2016 (NRI Student/Parent):

Period From To Relevant

page no.

of

passport

Total days

Inside India

I solemnly declare that I have personally checked and verified all the information

filled in this form and that they are correct and that no relevant information of fact is suppressed or omitted.

I undertake to abide by the decision / order of the Dean/Principal to cancel my

admission and/or to expel me from the college and/or to prosecute me in case any

incorrect information or discrepancy is found in this form either at the time of admission

or at any time during the course of my study.

I hereby agree, if admitted, to conform to the Rules and Regulations of the Medical

College in force and that may hereafter be made for the governance of the college and

undertake that so long as I am a student of the college I will do nothing either inside or

outside the college that will interfere with its orderly governance, discipline and good

name. Date: _____________________ _____________________ Place:

Signature of the Signature of the

Father/Guardian Student

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CHECKLIST Please tick (√) appropriate box of the documents you have submitted with this application. (Attach only the attested photocopies in the sequence given below)

1. School Leaving Certificate or other document showing place of birth. ( ) 2. H.S.C.E. / Equivalent Examination mark sheet. ( ) 3. NEET – UG – 2016 Examination Mark Sheet. ( ) 4. Transcript – for abroad student. ( ) 5. Equivalence Certificate – for abroad student. ( ) 6. Passport (Notarized color photocopies of all pages including

blank Pages) of NRI/NRI Parents ( ) 7. Visa / Resident permit / OCI / PIO card as applicable ( ) 8. Address proof (Indian and foreign) ( ) 9. Undertaking in regard for the fees from NRI Student/Parent ( ) 10. Document/s for Proof of Origin (Citizenship Card/P.R. Card etc.) ( ) 11. Self-addressed envelope ( ) 12. Any Other (please specify)

(a) _____________________________________________ (b) _____________________________________________ (c) _____________________________________________

Date: _____________________

(Signature of Candidate)

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FORMAT OF UNDERTAKING (TO BE NOTARIZED BY NOTARY PUBLIC)

FROM:

1. PARENT/LEGAL GUARDIAN [Name & Address]

2. STUDENT [Name & Address]

Date:

Sub: Undertaking in regard for the fees to be paid to the college

(1) I, Mr./Ms.__________________________________________________ (Name of the student) residing at_________________________________________________________________________

(2) We, Mr./Ms._________________________________________(Name of the Parent/Guardian) residing at ______________________________________ the former having been admitted to the 1

st year

M.B.B.S Course at your institute under NRI seat quota hereby agree, affirm and declare jointly and severally

that the fees of US $ {As described in prospect of concerned college} for entire M.B.B.S. course will be paid

by us to the said Institute for the entire course by installments as specified by the institute and the said fee

shall be neither negotiable nor refundable in full or part thereof under any circumstances except as provided

under the rules of admission and that thereof we will not raise the issue of refunding to us the said amount

at any time or under any circumstance.

We also agree and undertake to pay the additional fee as per clause 8(iii) of admission rules for

each term if the period of study is prolonged beyond the normal prescribed period of 4 1/2 years of

study and one year of internship due to any reason whatsoever. We also understand that if all the dues

are not cleared, the student may not be sent up for the examination.

Yours faithfully,

_________________________ ____________________________

PARENT/GUARDIAN STUDENT

The above declarations duly notarized by me. Mr./Ms. ________________________________________________________Notary Public.

Place: _______________ Date: _______________ Seal/stamp of Signature of the

Notary Public Notary Public

Notary Public Signature of the Notary Public [Stamp of the Notary Public]