East Coast Maritime Academy

(An Institute of Shipping & Logistics for Vocational Training)

Door No. 25-12-35/2, Indu Mansions, Flat No. 404, 4th Floor,Godeywari Street, Visakhapatnam-1.

Tel: +91 891 6692 017 / 6630 782, Fax : +91 891 2521 191.

Email: /

Application Form 2016-17

Application Number: ECMA/2016-17/ / Batch Applying for: January | July
  1. Fill up the details in English in CAPITAL LETTERS
  2. Use black ball point pen for filling the details
  3. Put Tick mark wherever applicable and strike out wherever required
  4. Please mention N.A. if not applicable
  5. All the Applications must be accompanied by attested copies of supporting documents
  6. Read carefully all the terms and conditions given in the Annexure-1 and sign it as a token of acceptance
  7. Student has to read and sign Annexure-2 Declaration
  8. Annexure – 3 Indemnity Bond by the Student & Parent / Guardian in Non-Judicial Stamp Paper
/ Affix
Passport Size
Photograph
Here
Course Applied for / Diploma | Advance Diploma | PG Diploma in Shipping & Logistics
B.Com| BBA|MBA in Shipping & Logistics
Personal Details:
  1. FULL NAME

  1. SURNAME

  1. Father’s Name

  1. Occupation of Father

  1. Mother’s Name

  1. Email ID

  1. Contact Number of the applicant

  1. Emergency Contact

  1. Next of Kin – Name, Contact No. Email ID and Relationship

  1. Date of Birth
/
  1. Gender
/ Male / Female
  1. Address

Permanent Address / Present Address
Pin Code: State: / Pin Code: State:
  1. Aadhar Number:

  1. Passport Number / Expiry Date:

  1. Nationality:

  1. Education Qualification:

Name of the Examination / Name of the School / Institution / Board / Year of Passing / % Scored / Subjects Taken / Medium of Instruction
10th
10th+2
Degree
  1. Special Courses taken / additional Qualification (if any)

  1. Employment Details

Name of the Company / Designation / From / To
  1. Personal Details

Height (CM) / Weight (Kgs) / Blood Group / Allergy (if any) / Medical History
  1. About Yourself

Hobbies
Interests
NCC/NSS
Sports
Cultural activities
A brief about yours Self
  1. Declaration

I confirm to the best of my knowledge that the information given in this Application form is accurate and I have thoroughly read and fully understood the terms and conditions as per Annexure-1 and declaration as per Annexure-2.
______
Applicant’s Signature Parent / Guardian Signature
  1. Enrolment Checklist:

5 Recent Pssport Size Photographs of Applicant in formals
2 Attested copies of Voter ID/Driving License/Aadhar Card/Passport/Ration Card (Any One)
2 Attested Copies of Transfer / Migration Certificate
2 Attested Copies of 10th, 10+2, Degree Certificate
2 Attested Copies of Conduct Certificate
Annexure – 1 duly signed by the Student & Parent / Guardian
Annexure – 2 duly signed by the Student & Parent / Guardian
Annexure – 3 Indemnity Bond by the Student & Parent / Guardian in Non-Judicial Stamp Paper
Original Certificates to be presented for verification
For Office Use only
Application Received on: / Verified by (Name):
Admission Approved by: / Verified by (Sign):

Annexure – 1

Terms and Conditions

  1. Enrolment for the course, together with payment of the required deposits creates a binding agreement to followthe course and pay the full fees. Even if a student subsequently decides not to complete the course, no refunds can be made as a seat has been committed to the student for the duration of the programme and the Academy will not entertain any request for refunds.
  1. Jurisdiction purpose, the Visakhapatnam court shall have exclusive jurisdiction in the matter and the laws prevailing in India shall apply.
  1. East Coast Maritime Academy offers tuition on a 'per course' basis and not based on number of hours of instruction which may vary, East Coast Maritime Academy further requires all students to attend lectures, classes, tests and to submit written work as assigned by lectures and tutors regularly, No classes will be scheduled on public holidays.
  1. Students will be charged a late fee of Rs. 500 per week per installment if he/ she fails to pay the tuition fee as per installment structure agreed.
  1. The students will be liable for all legal expenses incurred in recovering late or non-payment of tuition fee on an indemnity basis. In the event of such legal action taken by the training center against you, Academy reserves the right to claim the full amount due from the student.
  1. Academy reserves the right to dismiss the student from the course at any time if the student fails to fulfill the above requirements or if a student's continued presence would, in the opinion of East Coast Maritime Academy be detrimental to the well - being of the students and the staff in general. The refund of fees of an expelled student is wholly at the discretion of the Academy.
  1. The Student shall indemnify the Academy for any loss or damages occurring as a result of his / her negligence or willful misconduct during practical visits or during the process of training.
  1. If a student changes his / her course of study during the term, no refund will be given for the revised courses if the number of subjects involved are less than that for which original enrolment was accepted. Additional conversion fees will be charged if the change involves an increase in the number of subjects over that of the original enrolment.
  1. It is the responsibility of the student to ensure that he / she fully complies with the requirements and does the necessary examination registration with the relevant University / Examining body. In this respect, East Coast Maritime Academy will endeavour to assist the student in whichever way necessary. The student will be charged separately for these services.
  1. All representation made by the Academy regarding the awarding University / Examining body and the external programme are based on information made available by the University / Examining body and are comprehensively contained in East Coast Maritime Academy printed information or in Academy website. As the university reserves the right to change programme details without any notice to the student, Academy shall not be liable for any representations made about the University / Examining body which will therefore not be deemed as a term of enrolment.
  1. East Coast Maritime Academy reserves the right to cancel a course on two weeks' notice prior to the commencement date of the course whereupon any fees paid will be refunded in full.
  1. Academy reserves the right to withdraw a subject up to four weeks after commencement date. If it is considered that the subject is not viable whereupon an alternative subject will be offered or a pro-rated refund of the course fees given.
  1. Academy also reserves the right to vary the subjects offered, the timetable programmes scheduled and teaching staff so as to provide better services to the students or as may be required by the University/ Examining body or by the Ministry of Education.
  1. All Notes/ hand outs, class video tapes and other materials given to students are the intellectual property of East Coast Maritime Academy and are given to registered students of the class as consideration for enrolment who agree to respect the intellectual property rights of the Academy.
  1. By Becoming the Student of East Coast Maritime Academy / signing the application, you are termed to have accepted with free and full consent all the agreements and contract between you and the academy. And that you have also agreed and accepted all contracts and agreements concluded between East Coast Maritime Academy and Other Institutions / Companies, for the betterment of the course for which you have registered yourself.
  1. This training is not meant for 'JOB', this is for a “CAREER “and the student is expected to pursue this career for best results - Post Graduate Diploma, Advance Diploma and Diploma Programs - East Coast Maritime Academy conducts its own programs in Shipping & Logistics and in other related sectors.
  1. We do not teach any Foreign Institute courses. These Courses does not come under the purview of AICTE.
  1. In case the student discontinues the course at any stage or he / she been dismissed from the course, the fees once paid by him / her will not be refunded. If the student is paying the fees in parts, then only after the payment of full fees of the course he / she shall be relieved from the course.
  1. Admission to the course is subject to satisfactory performance Online Entrance Examination and Interview conducted by the Academy at Visakhapatnam and the right of admitting a student in a course is reserved to the academy.
  1. The Student, by filling and duly signing the application, states and declares his/her consent to abide by all the rules and regulations framed by the institution which may be amended from time to time for the betterment of the course /student community.
  1. The institution reserves the right to make new policies and take decisions at any time for the betterment of the course / student community.
  1. The student is expected to follow utmost discipline both inside and outside the campus, failing which he / she shall be liable to be dismissed from the course immediately.
  1. East Coast Maritime Academy will deal with the current batch students only when the students are in formal attire like uniform with tie, shoes and ID card from Monday to Friday. On Saturday smart casuals with ID card and shoes may be allowed.
  1. Minimum attendance required by the Academy is 90%.
  1. Any student whose Attendance is Less than 90% but above 60% shall pay a condonation Fee of Rs.500/- (Rupees Five hundred only) for every 1% shortage.
  1. Any student having less than 60% attendance but, above 50% shall pay a condonation fee of Rs.1000/-(Rupees one thousand only) for every 1% shortage.
  1. East Coast Maritime Academy reserves right of admission to the courses/ programmes
  1. Students are to: a. Attend mandatory pre-finals exams for internal marks, failing which students have to regularize by remitting Rs. 1000/- for each paper b. To remit a fee of Rs. 3,500/- towards 2 sets of uniform material and shoe c. No student shall be allowed to enter the classrooms without Academy uniform, ID card and formal shoes.
  1. Usage of mobile phones inside the classrooms is strictly prohibited. Smoking and Drinking in the Hostel are strictly prohibited.

Annexure – 2

Declaration by the Student

I,…………………………………………...... Son/Daughter of………………………. Residing at (Completed Postal address and Phone Number)………………….. ……………………...... ………………………………………………………………….. ………………………………………………..………………………………………………………………………………… Solemnly affirm and undertake the following:

  1. I, having got admission in “East Coast Maritime Academy”, shall undergo the program of study as a responsible and disciplined student.
  2. I am applying on my own and I have been adequately briefed about the Vocational Training Programs, applicable fees, Rules and Regulation and other information pertaining to my study. I have fully prepared myself accordingly.
  3. I am aware and have fully understood all the rules and regulations, codes and practices of the Academy and shall strictly adhere to the Rules and regulations that are in force in the Academy.
  4. I shall not indulge in any act of indiscipline, misbehavior, unethical, immoral, anti-social, anti-national or criminal activities during my entire period of study at your Academy.
  5. I shall pay all the applicable fees which include tuition, accommodation, food, examination fees, academic expenses and other miscellaneous fees related to my studies, on the prescribed dates, during my entire period of study.
  6. I am aware that, in the eventuality of not adhering to or acting in violation of any one of the above undertakings, at any point of time during my study period, I shall forfeit my admission. Neither I nor my parents shall recover any sort of damages from the Academy. I shall also immediately arrange to leave the Academy to my home town on my own expenses.
  7. Also, I hereby declare that I have not been expelled or debarred from admission in any institution on account on being found guilty of, abetting or being part of a conspiracy to promote ragging or due to any other reason; and further affirm that, in case the declaration is found to be untrue, my admission is liable to be cancelled.

(To be typed in Non-Judicial Stamp Paper as per the State Rules)

Annexure – 3

To

The Principal,

East Coast Maritime Academy,

Visakhapatnam.

Dear Sir,

Indemnity for Personal Safety

This is to state that I,……………………………………………………………………… Son of …………………………………………………………………………………………

have joined the Diploma / Advance Diploma / PG Diploma course, on my own accord and I am aware of the personal safety aspects to be maintained while under training. I agree to abide with the rules of the Academy and will keep myself updated with any alterations to rules in the future during the tenure of my training.

In particular I assume all risk and expenses towards personal injury, loss of life, hospital, medical expenses, loss or damage of property or any other loss or damage whatsoever and howsoever caused.

I confirm that I shall maintain strict discipline and adhere to all safety procedures during my training at the Academy, and at any other location I may be sent to for further training, for the course.

I will not hold EC Maritime Academy or any staff thereof responsible for any injury that I may suffer due to any breach of this undertaking.

I expressly agree that the ECMA or any other Organization involved in the training shall not be held responsible notwithstanding any express or implied condition or warranty to the contrary, statutory or otherwise.

I declare that I am in sound health to undertake the above Course in all aspects and I will not hold the Academy responsible for any hidden / undisclosed medical reports and health conditions.

______

Parent / Guardian’s Signature Student’s Signature