Hostel Form

Student Photo*

Local Guardian Photo (optional)

Basic Details

First Name*

Middle Name

Last Name

Gender*

Email*

Contact Number*

Academic Session* (For eg. 2014-2015, 2015-2016)

Program Type*

Course* (For eg. BA,BSc,BCom,MA,MSc,MCom)

UG Honours subject/ PG subject/ PhD subject *

Name of Department/College/Institution*

Roll Number*

Student's Permanent Address

Address*

City*

Pin Code*

State*

Police Station*

Father Details

First Name*

Middle Name

Last Name

Father Occupation*

Father's Address

Same as Student's Address

Address*

City*

Pin Code*

State*

Local Guardian Details

First Name

Middle Name

Last Name

Relationship with Guardian

Guardian Contact Number

Local Guardian's Address

Address

City

Pin Code

State

Student Aadhar Card*

Father's/Local Guardian's Aadhar Card*

[Note: Max allowed image size is 1Mb and allowed formats are .png, .icon, .jpg, .jpeg, .gif]

Declaration: I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences.

Signature of Student:

- - - - - To be filled by Department/College - - - - -

Recommendation of Head of University Department/ College Principal With Signature and Seal :

______________________________

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(Hostel Application Form Fee - Rs. 100/-)

Documents to be Produced at the time of Hostel Allotment:
1. Xerox of Aadhar Card of Student and Father
2. 4 Photograph duly attested by HOD/Principal of respective college/department.
3. Last Examination Passing Marksheet.
4. Last Admission Receipt
5. Admit Card of Last Examination

Hostel Form Id*

Email*

Contact Number*

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