Uka Tarsadia University, Bardoli lll Imparting Knowledge. Awakening Wisdom. Transforming Lives. 2016030050107 ‘APPLICATION FOR ANNUAL CONVOCATION To, The Registrar Uka Tarsadia University, Tarsadi, Bardoli - 394350 af Ae sir, en Sette | hearby apply for Degree of the University at the ensuring convocation to be held on 14 October 2016 in Person. PERSONAL DETAILS Name : Bundela Jay Bharatbhai Gender : Male Postal Address : 23,Rangila park, Near Mahalaxmi Temple, Anand mahal Road, Adajan, Surat. Postal Code : 395009 Mobile No. : 9998962471 Name of Degree : Bachelor of Technology (Mechanical Engineering) Faculty Name : Engineering and Technology Passing Year & Month : Summer 2016 Class Obtained :Second —-CGPA: 6.56 Name of Collage / University Department : Chhotubhai Gopalbhai Patel Institute of Technology Instructions to Candidate The prescribed convocation fees Rs. 1500/- should be paid in cash or by demand draft in favour of "Uka Tarsadia University", payable at Bardoli. Please write your name and enrollment no. at the back of the demand draft. 2. Fees once paid cannot be refunded or held in reserve for a future convocation. 3. The convocation fee receipt should be preserved carefully and produced at the time of collection of the degree /diploma certificate on the day of the convocation, or as and when the same is collected. 4. Incomplete Form will not be accepted. 5, Candidates who intend to receive more than one degree at the same Convocation should send a separate prescribed application form for each degree, with required fees. 6, The degree certificates will be sent to them in due course at the address given by them in their application by post. Complaint regarding non-receipt of Degree certificate will be entertained within two months from the date of convocation, thereafter no complaint will be entertained. 7. Candidates applying for admission to the degree of Bachelor of Physiotherapy, B. Pharm. Or Nursing are requested to attached zerox copy of the Training / Housemnanship / Internship certificate, as the case may be or they should mention No. ‘and date of such certificates, as the case may be, failing which they will not be admitted to the Degree at the Convocation. £8 You are requested to wear scart / gown for convocation ceremony. You can collect it fram university reception office. Declaration By Candidate | have carefully read & noted the instructions to the candidate before filing in this form. declare that the information given above is true and correct to the best of my knowledge and belief. | undertake that | shall be responsible for any omission / errors / incomplete entries made by me in this form, Date : Place Signature of Candidate FOR OFFICE USE ONLY Receipt No. Amount Enrollment No : 201303100520005 Form Checked By Datere UKA TARSADIA len Form Name : Bundela Jay Bharatbhai Name of Degree : Bachelor of Technology (Mechanical Engineering) Faculty Name : Engineering and Technology Note: Kindly Adjudicate the Thesis under given heads and grade then on the scale of 5. Please answer all 30 questions. Grade 5 4 3 2 1 Excellent and Not satisfactory and Interpretation Very Good Good Satisfacton P strongly agree y Y not agree [criteria 1: Details of courses/subjects studied No. [Sub Criteria [grade 2.3 [Fulfllment of Objectives of courses 2 [Fundamentals Coverage of courses 23 [Depth of Course Coverage 14 [Relevance of Subjects with Practical/Lab Work 15 [Sylabusis suitable to the Program 3.6 [The course/syllabus has good balance between theory and application. 1.7 [Course content is followed by corresponding reference materials as mentioned in syllabus of course [8 [Sufficient number of prescribed books are available in the Library ‘Sub Total criteria 1; [Criteria 2: Teachers’ Course Command - Teaching Methodology/Pedagogy [2.2 __[Self Confidence in teaching subject [2.2 __ [Delivery of subject content in the class/ Ability to present the subject clearly 2.3 [skill of linking subject to real life experience /situation [2.4 [Skill of linking subject to other subject of your program 25 [Ability to create interest in the subject [2.6 __ [The teacher completes the syllabus [2.7 __|Keep laboratory ready for experimentation [2.8 [Use of Modern Teaching tools/ICT in the class [2.9 __ [Refers to the latest development in the subject and encourages for career development 2.10 [The teacher encourages participation and discussion in class. [2.11 [Regular and timely feedback is given on our performance. [2.12 _ [Periodical internal assessments are conducted as per schedule,Student Evaluation of the Department/inst No. [criteria [Grade 3.1 [class Room Facilities [3.2 [Library Facilities [3.3 [Laboratory Facilities [3.4 _ [Cleanliness of the Department/inst [3.5 __[Avallabilty of administrative assistance 3.6 [The campus is green and eco-friendly; pollution-free [3.7 |The campus has adequate power supply [a8 [Internet services [3.9 [Transportation services 3.10 [Parking facilities Your opinion/suggestion for improvement in criteria, land i ‘Sub Total criteria 3 Signature Date =