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    Annexure C Important Dates and Checklist For Registration

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    b24219

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    Annexure C Important Dates and Checklist For Registration

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    b24219
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    Annexure C Important dates and checklist for registration

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    3 views5 pages

    Annexure C Important Dates and Checklist For Registration

    Uploaded by

    b24219

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    ANNEXURE - `C’

    IMPORTANT DATES
    Preparatory Sessions on Fundamentals of Excel;
    1. Accounting; Quantitative Techniques and Case May 08 – June 08, 2024
    Study Analysis [Online]

    2. Inauguration of Academic Year 09:00 am on June 10, 2024

    3. Orientation & Registration for Freshers 10:30 am on June 10, 2024

    Please make sure that you reach XLRI by June 09, 2024

    CHECKLIST FOR REGISTRATION

    a) Latest Passport size photograph on white background [2 nos.] 5.0 cm x 4.5 cm.
    The face (including the hair, to the bottom of the chin) must be around 70% of the
    1. Photograph.

    b) Latest Stamp size photograph on white background [1 no.] 2.5 cm x 2.0 cm


    ORIGINAL MARK SHEETS:

    a) SSC / HSC / Class X Mark Sheets.


    b) Pre-Degree / Intermediate / Class XII Mark Sheets.
    c) Year-Wise Mark Sheets of Graduation and Post-graduation.
    2. d) Original Certificates for completion of Graduation [Degree / Diploma] given by your
    Institute / College / University clearly indicating the aggregate percentage of marks
    obtained.
    e) If your Final Graduation results are not yet declared, please bring a Provisional
    Certificate / letter from the Principal of your College / Institute stating that you have
    attended the graduation exams and have cleared all the dues.
    3. GMAT Score Card [If Applicable]

    4. SC / ST / OBC Certificate [If Applicable]


    Work Experience Certificate from all Previous Organisation[s] [with relieving Letter or grant
    of leave from your organization you worked last].
    5.
    For future references these work experience certificates will be used. No further
    modification will be accepted.
    Medical Report [with Blood Group] and Fitness Certificate is required from a registered
    6.
    Medical Practitioner. [Format Attached]

    Kindly carry scanned copies of all the documents mentioned in points 2-6 above with you in a pen drive.
    These will be uploaded by you during the online registration process on June 10, 2024, in our Computer Lab.
    Medical Information

    I. Particulars to be entered by the applicant in block letters:


    Name in full _____________________________________________________
    Father’s / Mother’s / Husband’s Name ________________________________
    For the course ___________________________________________________
    II. Age: Yrs Date of Birth: / / (Date/Month/Year)
    III. Identification Mark: (a) (b)

    IV. Please go for a comprehensive health check-up and get the diagnostic tests done by a
    reputed pathological laboratory like Thyrocare, Apollo or any other good Centre. Please
    attach the report along with this form.

    V. Have you any previous history of: (Kindly provide us the correct information which may be
    required in case of any emergency)
    Any record of Covid-19 (Attach the Vaccination
    1
    Certificate)
    2 Jaundice
    Nervous system ailments like convulsion, vertigo, fits,
    3
    headache with vomiting
    4 Lung trouble/Asthma/Bronchitis/Pneumonia
    5 Recurrent Sore Throats, Joint Pain
    6 Congenital or acquired Heart problem
    7 Chronic Indigestion or other Bowel Troubles: Hepatitis B
    8 Tropical Diseases
    9 Venereal Diseases
    10 Eye Trouble: If Glasses are worn state
    a) for constant use
    b) for reading only
    11 Deafness or Ear discharge
    12 Nausea or Vomiting on swings, Roundabouts etc.
    13 Any Serious Operation
    14 Any other illness during the last ten years
    VI.

    1 Are you taking any medicine these days - give details?

    Are you/were you under treatment for any chronic


    2
    condition - give details
    Has any of your close family members suffered from
    3
    hypertension, diabetes, heart disease? If so, give details
    Have you suffered from any psychiatric condition,
    4
    nervous ailment? If so, give details
    Any significant menstrual I gestational history (for female
    5
    candidates)

    All the answers given above are true and correct as per best of my knowledge & belief.

    Candidate's Signature with Date

    Note: The candidate will be held responsible for the accuracy of the statement. Willful
    suppression of any information will invite expulsion from the Institute.
    CERTIFICATE OF MEDICAL FITNESS

    This is to certify that I have conducted the medical fitness test of ….…………………………. who is
    desirous of admission to XLRI, Jamshedpur.

    He/She has not given any personal history of any disease making him/her unfit for admission to this
    Institute.

    I certify the results for the following:

    • Any incapacitating and/or progressive systemic disease YES / NO


    • Any disability of upper limb YES / NO
    • Any major visual / auditory disability YES / NO
    • Psychosis / Neurosis / Mental retardation YES / NO
    • Any disability to maintain erect posture YES / NO

    He / She has been vaccinated against COVID-19


    • Dose 1 YES / NO
    • Dose 2 YES / NO
    • Booster Dose YES / NO
    He / She has been vaccinated against Chicken pox YES / NO

    His / Her blood group is ………………………………………

    I hereby declare him / her fit / unfit for admission to XLRI, Jamshedpur to the best of my knowledge
    and ability. He/She can undergo the programme and complete all the associated activities viz.
    Adventure Programme and the Village Exposure Programme which is mandatory part of the
    programme.

    Signature:

    Name [BLOCK LETTERS]:_______________________________________________

    Registration Number: ______________

    Address of Registered Medical Practitioner:


    Annexure

    PSYCHOLOGICAL INFORMATION:

    Mental health explains a level of psychological well-being, signifying a successful


    adaptation to a range of life’s circumstances, challenges and stressors. Please help us
    understand you better through giving us details about your psychological history, family and
    life circumstances. These details shall be treated as strictly confidential dealt only under the
    Department of Psychotherapy and Counselling, XLRI, Jamshedpur.

    Please fill the following set of questions which will help us comprehend you better. The
    questions are based on few domains of our quality of life. Those are physical health,
    wellbeing, autonomy, choice and control, attention, concentration, self-perception, hope and
    hopelessness, relationships and belonging. The right answers will give us insight not only to
    deal with your wellbeing but also promote your concern for others and encourage each
    other to seek professional help if necessary.

    Head
    Department of Psychotherapy and Counselling,
    XLRI, Jamshedpur.

    Please note: The below questions are not a part of any psychological/psychometric
    testings. These are not part of any standardized scale but general mental health
    questionnaire. These are meant for your taking information to deal with any stressors
    you face while being on campus and the aforesaid department is available for
    assistance during your two-year programme stay in the hostel. The accuracy and
    honesty in your answering these questions will be helpful to both you and the
    department in dealing with our future endeavors.
    PARTICULARS TO BE ENTERED BY THE APPLICANT IN BLOCK LETTERS:

    Name in full ____________________________________________


    Father’s/ Husband’s Name ________________________________
    For the course __________________________________________

    II. Age: Yrs Date of Birth: / / (Date/Month/Year)

    Following are close ended questions with yes/no format: please tick one of the answers:

    Sl.
    Questions Yes No
    No.

    1 Have you visited a psychiatrist/psychotherapist/psychologist ever?

    2 Have you been prescribed any psychiatric medications?

    3 Any family history of mental disorder/illness diagnosed?

    4 Any changes in sleep patterns? Difficulty sleeping or restlessness?

    5 Any changes in appetite and eating patterns?

    6 Are you troubled by not being able to focus or concentrate?

    7 Are you bothered with low mood, stress or sadness?

    8 Do you feel little pleasure or no interest in the activities you enjoyed earlier?

    9 Are you bothered by not being able to stop worrying and overthinking?

    10 Do you feel your life is under your choice and control?

    11 Do you feel confident about your capabilities around everything you do?

    12 Do you feel self-assured and satisfied with yourself during past few months?

    13 Do you feel hopelessness about your future?

    14 Do you feel supported by others around you-family, friends, and


    relationships?

    15 Do you feel less connected with relationships at large?

    16 Do you feel lethargy and tiredness over past few weeks?

    17 Do you feel fidgety and restlessness over past few weeks?

    18 Do you feel fear or something terrible/bad may happen?

    19 Do you feel you are unable to trust people?

    20 Do you feel angry and irritable since last few weeks?

    21 Do you feel you can manage obstacles of life as challenges?

    ****

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