SCHOOL OF PHYSICAL EDUCATION DEVI AHILYA UNIVERSITY, INDORE Annexure-I DETAILS OF SPORTS ACHIEVEMENTS S. N. Name of the Competition Name of Game Name of the Institution Represented Year Position 1 2 3 4 5 6 7 8 9 10 Note:- Attach the attested photocopy of the certificates OPTION OF THE GAME FOR ADMISSION TEST:- B.P.E./M.P.Ed. (Any One Game):- 1.________________ List of Games for Option:Hockey, Football, Volleyball, Basketball, Tennis, Badminton, Table Tennis, Cricket, Judo, Hand ball, Kho-Kho, Kabaddi, Swimming, Gymnastics, Wrestling, Weight lifting, Yoga, Track & Field (Two events – one Track and one field event) Note: - The School of Physical Education has the rights to include or delete any game according to administrative feasibility. Name of the Applicant Signature of the Applicant Annexure – II DEVI AHILYA UNIVERSITY, INDORE MEDICAL CERTIFICATE (To be certified by a Registered Medical Officer) 1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Name:-_________________________________Sex:- ______(M/F) Blood Gr.__________ Height (in cm):-____________________ Weight(in kg):-___________________ Physical appearance and Musculature:Robust/Average/Weak Previous History of Fracture or other injuries (Give Details):_________________________________________________________________________ _________________________________________________________________________ C.N.S.:-__________________________________________________________________ C.V.S.:-__________________________________________________________________ Respiratory System:-________________________________________________________ Liver:-___________________________________________________________________ Spleen:-__________________________________________________________________ Hernia Site:-______________________________________________________________ Throat:-__________________________________________________________________ Ears (Perforation/Discharge/Any other) :-_______________________________________ ________________________________________________________________________ Hearing:-_________________________________________________________________ Eyes:-______________________ Vision(Without Glass):-__________________________ Color Blind (Partial/Complete):- ______________________________________________ Any Body deformity (Such as Kyphosis, Lordosis, Scoliosis, Knock Knee, Bow Legs Flat Feet etc):-________________________________________________________ History of Epilepsy, Asthma, T.B., V.D., Allergy, etc.:-____________________________ ________________________________________________________________________ Sensibility to drugs ,if any :-_________________________________________________ I certify that I have this day carefully examined (Name)___________________________ And have recorded my observation as given above. I am satisfied that he /she is fit/unfit for undergoing training in Physical Education which involves strenuous physical activities and competitive games. I further certify that the candidate has been inoculated/vaccinated for: (a) Tetanus:__________________ (b) Typhoid :______________________ (c) Chickenpox :______________ (d) Hepatitis-b:____________________ (e) Any Other:________________________________________________________ Signature of the Candidate Date:_____________ Signature:_____________________ Name:________________________ Reg. No.______________________ Address:______________________ Seal: CHECK LIST OF ENCLOSURES FOR APPLICATION FORM Annexure – I (Details of Sports Achievements) Annexure – II (Medical Certificate) Photocopy of 10th Mark sheet Photocopy of 12th Mark sheet Photocopy of B.P.E./B.P.Ed./B.Sc.(Phy.Edu.) Mark sheet (for M.P.Ed. Admission) Photocopy of Last Examination Mark sheet (If applicable) Photocopy of Transfer Certificate Photocopy of Characteristic Certificates Photocopy of Migration Certificate (If applicable) Photocopies of Sports Achievements Certificates Other Docume nts for SC/ST/OBC Candidates Photocopy of Caste Certificates Photocopy of Income Certificate of Father/ Parents Photocopy of Domicile of Madhya Pradesh SUBMISSION OF APPLICATION FORM Candidates should submit application form on or before last date at Office of the School of Physical Education, Devi Ahilya Vishwavidyalaya, Takshashila Campus, Khandwa Road, Indore (M.P.) Last Date for Submitting the Application Form (Dates Extended) M.P.Ed.: By Post and By Hand – July 04th 2014. B.P.E.: By Post and By Hand – July 08th 2014. For further details contact or write to: Prof. S. K. Yadav Head School of Physical Education Devi Ahilya University, Takshashila Campus, Khandwa Road, Indore-452001 Phone: (O) 0731-2910313, (Mob.) 098265 35933 www.sope.davv.ac.in SCHOOL OF PHYSICAL EDUCATION DEVI AHILYA VISHWAVIDYALAYA, INDORE ENTRANCE TEST for M.P.Ed. 2014-2015 Schedule of Test Monday 07th July 2014 (a) (b) (c) 08.00 am to 10.30 am 11.00 am to 01.00 pm 03.00 pm to 06.30 pm - Checking of Original Certificates - Written Test - Game Test Tuesday 08th July 2014 (a) 05.00 pm - Declaration of Result Friday 11th July 2014 - Last date for submitting the fee for first merit list candidates Monday 14th July 2014 - Last date for Submitting the Fee for Waiting list candidates Tuesday 15th July 2014 12.00 noon - Assembly and Inauguration of Course. Note :1. 3. 2. All written and practical test will be conducted at School of Physical Education, Devi Ahilya University, Takshashila Campus, Khandwa Road, Indore. Candidates have to attend the practical test in prope r sports kit. Waiting list candidates will contact the office on Saturday 12th July 2014 at 11.00 am for confirmation of admission and submission of fee. Prof. S. K. Yadav (Head) SCHOOL OF PHYSICAL EDUCATION DEVI AHILYA VISHWAVIDYALAYA, INDORE ENTRANCE TEST for B.P.E. 2014-2015 Schedule of Test Thurs day 10th July 2014 (a) (b) (c) 08.00 am to 10.00 am 10.30 am to 11.30 am 02.30 pm to 05.30 pm - Checking of Original Certificates - Written Test -Modified AAHPER Fitness Test Friday 11th July 2014 (a) (b) 07.00 am to 11.00 am 2.00 pm to 5.30 pm - Game Test - Game Test Saturday 12th July 2014 (a) 05.00 pm - Declaration of Result Thurs day 17th July 2014 - Last date for submitting the fee for first merit list candidates Saturday 19th July 2014 - Last date for Submitting the Fee for Waiting list candidates Monday 21th July 2014 12.00 noon - Assembly and Inauguration of Course. Note :1. 2. 3. All written and practical test will be conducted at School of Physical Education, Devi Ahilya University, Takshashila Campus, Khandwa Road, Indore. Candidates have to attend the practical test in prope r sports kit. Waiting list candidates will contact the office on Friday 18th July 2014 at 11.00 am for confirmation of admission and submission of fee. Prof. S.K.Yadav (Head)
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