PROSPECTUS

ADVANCED DIPLOMA IN INDUSTRIAL SAFETY (For the Academic Year : 20 -20 )

Department of Chemical Engineering of

Karmaveer Kakasaheb Wagh Education Societys

KARMAVEER KAKASAHEB WAGH POLYTECHNIC

Hirabai Haridas Vidyanagari, Amrut Dham, Panchavati, Nashik- 422 003 (Maha.) Phone Nos.- (0253) 2516675,2516671, 2512867 Ext. 112, 2517006, Fax No. (0253) 2517006, 2511962 Website: kkwpoly.org Email: kkwpoly@rediffmail.com

1) ABOUT THE COURSE: Nashik boost around seven MIDC with around 3000 small, medium scale and large scale industries yielding (EHS) Environment Health and Safety of working professionals and people living in adjoining area is critical requirement of joining as social and legal mandate. Nashik is the only under develop vertex for Munbai-Pune-Nashik golden triangle. Therefore at present it is focal point of Industrial and real estate development after Mumbai and Pune. The sanctioning of two SEZ for Nashik is the testimony of this. Therefore there is a great a requirement of safety professional in and around Nashik and K.K.Wagh Polytechnic, Nashik want to fill this vaccume by creating education facility to cater the needs of various safety professional in various sectors. 2) AFFILIATION: The institute is affiliated to the Maharashtra State Board of Technical Education, Mumbai and approved by Directorate of Technical Education, Mumbai. 3) DURATION: This course is a FULL TIME Course and the duration of the Course is One Year (Two Semester). The course will commence in month of July. 4) METHODLOGY: The Course will be conducted through lecturers, discussions, case studies, Laboratory exercise, relevant film shows, Factory visits etc. The students are required to carry out one project work, four term works and two laboratory works during the course of the programme, as per MSBTE guidelines. The students will have to appear for Final Examination which will be conducted by Maharashtra State Board of Technical Education, Mumbai. MSBTE, Mumbai. 5) QUALIFICATION & EXPERIENCE: B.Sc. In Physics / Chemistry / Agriculture / Horticulture / B.Sc. In Life Sciences or its Equivalent from a recognized statutory University / Board or Degree / Diploma in Engineering, Technology with 2 Years Experience as Two years experience in Manufacturing maintenance or safety department of a factory OR Two Years Experience in Research, Training Education, Consultancy in Safety OR Two Years experience in enforcement of legislation pertaining to safety. 6) FEES AND OTHER CHARGES a) Course Fees: Rs 20,000/- to be paid by crossed Demand Draft (Separate Demand Draft) drawn in favour of Principal, K. K.Wagh Polytechnic, Nashik . Rs. 2,000/- to be paid by cash for course material. This fees once paid is not refundable. The Examination is of Theory Papers, Project Work, Term Work and Practicals. The Diploma will be awarded to the successful candidates in Examination by

b) Caution deposit: Rs.1000/- to be paid by paid by cash in favour of Principal, K.K. Wagh Polytechnic, Nashik.

c) Enrollment and Examination Fees: Enrollment, Examination other fees as prescribed by the MSBTE, Mumbai, payable by the student. d) Other Expenses: The expenditure towards purchase of books, stationeries, preparation of Project/Term Work reports, TA/DA charges in connection with the local/outstation factory visit, Seminar fee etc, are to be borne by the sponsoring organizations/ students. 7) SUBMISSION OF APPLICATION: The prescribed application complete in all respects, together with attested copies of certificates, shall be sent to the Principal, K.K.Wagh Polytechnic, Nashik. Incomplete applications will be summarily rejected. The last date of receipt of duly completed applications at this Institute is 25/06/2009 at 3 :00p.m. 8) SELECTION: The candidate selected after preliminary screening will be called for interview at this Institute during the Second fortnight of June 09. The exact date of interview will be intimated individually to the candidates. The mere calling for interview does not guarantee selection. No TA/DA will be paid by this Institute for attending the interview. The candidates should produce all original certificates at the time of interview. Certificates will not be accepted. Otherwise they need not appear in the interview. candidates are required to join the course at short notice. Provisional Selected

Karmaveer Kakasaheb Wagh Education Societys

KARMAVEER KAKASAHEB WAGH POLYTECHNIC

Hirabai Haridas Vidyanagari, Amrut Dham, Panchavati, Nashik- 422 003 (Maha.) Phone Nos.- (0253) 2516675,2516671, 2512867 Ext. 112, 2517006, Fax No. (0253) 2517006, 251962 Website: kkwpoly.org Email: kkwpoly@rediffmail.com

Application form for admission to ADVANCED DIPLOMA IN INDUSTRIAL SAFETY

Instructions to candidates: Please furnish all information in full. Attach separate sheets wherever the space in the form is inadequate Attach attested copies of testimonials of age, qualification, experience, caste, etc including marksheet for qualifying examinations. Last date for receipt of filled in application : 25/06/2009 The course will commence w.e.f : 01/07/2009 1 Full Name (as per SSC Cert. in BLOCK LETTERS) 2 3 4 Fathers Name Date of Birth Residential Address

Pin Code: Contact No Land Line No. : Mobile No. Email ID 5 Present Address : :

Are you a member of SC/ST/OBC/VJ/NT (If yes, please mark)

Yes / No

Entry qualification for admission to ADIS course acquired from Maharashtra

Yes / No

8.

Details of Academic Qualifications* (SSC onward in chronological order)

(Attach separate sheet, if required)
Examination Passed Board / University Year of Passing Marks Obtained out of % age Class Division

*NOTE: Those students who have passed degree / diploma (Entry qualification for ADIS Course) form outside Maharashtra State have to obtain Eligibility Certificate from MSBTE within one months.) 9. (a) Details of Experience (in chronological order) Attach separate sheet, if required
Name and Address of organization Period From To Years & month Designation Nature of Duties (Enclose Certificate)

9. (b) Total Experience (as on 01/07/2009 ) : ______________ Years ___________ Months. After obtaining desired qualification 10. Details of papers published, if any / Training undergone:

11. Extra curricular activates, if any:

12. Any other information the applicant desires to give in support of the application:

13. Are you sponsored?

(if sponsored furnish the certificate given on Companys Letter Head)

: YES / NO DECLARATION / UNDERTAKING BY CANDIDATE

I hereby declare that the information furnished in the application is true and correct to the best of my knowledge and belief and that no information has been suppressed by me. I also understand that I will be disqualified in the event of any information being found incorrect.

I, undertake to produce all the original certificate, testimonials etc. regarding my educational qualification, experience etc. at the time of Interview, training which, I accept for the rejection of my qualification to the course.

Place : __________________ Date: ___________________ (Signature of the Candidate)

CERTIFICATE BY SPONSORING AUTHORITY 1. We hereby sponsor Shri._____________________________________________ for the

Advanced Diploma in Industrial Safety Course 20 to 20 2. Shri._______________________________________________ joined this organization on

___________ as __________________ and at present he is working as ____________ _______________ form _____ to ________. 3. On his selection, he will be fully relieved one academic year to attend classes, do the project work and also appear in the examination.

Place: __________ Date: ___________

(Seal)

.. (Signature of Sponsoring Authority)

FOR OFFICE USE ONLY

APPLICATION NO. 1 2 3 Sponsored Is sponsorers certificate attached? Is the candidate belongs to : a) Government (Central / State) organization b) Government of India Undertaking c) Private organisation 4 5 6 7 8 9 10 11 12 Qualification (ME/BE/Dip. In Engg./Ph.D./M.Sc./B.Sc./ Others) Application Accepted If not accepted, mention reasons Entry qualification for admission in ADIS Course 2009-10 Total Experience after necessary qualification Called for Interview Selected Hostel accommodation given Selection committee remarks: Date Yes No Yes Yes Yes No No No DATE: Yes Yes / /2009 No No

.. (Seal of Institution)

.. (Signature of the Principal)

K. K. Wagh Polytechnic
(Affiliated to MSBTE & Approved by DTE, Mumbai) Hirabai Haridas Vidhyanagari, Panchavati, Nashik 422 003.

Ph. No. (0253) 2516675, 2516671 (Extn. 113) Web : www.kkwpoly.org Email : kkwpoly@rediffmail.com

ADMISSIONS OPEN (2009-10)

Course Name Advanced Diploma In Industrial Safety Intake 30 Duration One Year

Eligibility : B.Sc. In Physics / Chemistry / Agriculture / Horticulture / B.Sc. In Life Sciences or its Equivalent from a recognized statutory University / Board or Degree / Diploma in Engineering, Technology with 2 Years Experience as Two years experience in Manufacturing maintenance or safety department of a factory OR Two Years Experience in Research, Training Education, Consultancy in Safety OR Two Years experience in enforcement of Legislation pertaining to safety.

Admission procedure will be as per state government rules. Prospectus & Information Brochure along with Application Forms are available in office on cash payment of Rs. 200/- from 15/06/2009 to 22/06/2009. Last date of submission of application from 25/06/2009.

Letter to Principal

Date :- 17/09/2008 To, The Principal, K.K.Wagh Polytechnic, Nashik-03

Subject:- Approval for the Fee Structure 0f Advanced Diploma In Industrial Safety (IT) Dear Sir, As Per the DTE Circular:- Approval 2008/(119/08)/TE-06 Dated :- 25th Aug 2008 Advanced Diploma in Industrial Safety is commencing from academic Year 2008-09 in K.K.Wagh Polytechnic. To start the admission procedure it is mandatory to decide the Fee Structure. As Per MSBTE circular: MSBTE/K-50/Fee structure 2008/2245 Dated 25th Feb 2008 The Fee Structure is as Follows: Tuition Fees: - 14000/Development Fees:- 1000/In addition to this we can charge Rs 3000/- as a Course Material Fees. So kindly acknowledge the same. Thanking You,

K. K. Wagh Polytechnic
Hirabai Hridas vidyanagari, Amrut Dham, Panchavati, Nashik - 422003

Walk-In-Interview
The post of Lecturer (Advance Diploma in Industrial Safety) is to be filledQualification & Eligibility: B.E. with 1st Class (Any Discipline) + Advance Diploma in Industrial Safety with 5-8 years Industrial Experience related to safety field OR B.E. with 1st Class (any Discipline) with 8-10 years Industrial Experience as a Safety Officer. Candidates are requested to come in person with all authentic documents for written examination & interview at 11.00 a.m. on 20/06/2009 (Saturday) at K. K. Wagh Polytechnic, Hirabai haridas Vidyanagari, Amrut Dham, Panchaati, Nashik. Candidate must bring all original documents along with passport size two photographs at the time of interview. Principal