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GURU NANAK INSTITUTIONS Ibrahimpatnam, R.R. District-501506, Ph: (0/95) 8414-202120/21/23, Fax: 08414-223344 |
HOSTEL ACCOMMODATION APPLICATION FORM
A nnual Charges : Rs. Room Allotted:
Name of the Student :
N
Paste
your recent
Passport size photograph
Date of Birth (DD / MM / YYYY):
A ny Chronic Sickness :_________________________________________________
Date of Joining the Hostel :
E -Mail :______________________________________________________________
A adhaar Card No.: PAN Card No.: H.T.No.:
Name of the Father / Guardian :
Occupation of the Father / Guardian :____________________________________________________
Father / Guardian Contact Phone No(s).:
Father / Guardian Designation / Profession :___________________E-Mail:______________________
O ffice Address (if any) : _______________________________________________________________
Name of the Mother :________________________________Ph No.:
A
Permanent __________________________________________________________________________________________ _____________________________
Pin
Home
(Landline):
Office
(Mob.): Phone
(Landline):
Phone
(Mobile) :
Present
___________________________________________
_ __________________________________________
_ ______________________________ Pin
Mob No. (Father) :
M ob. No.(Mother) :
M ob. No. (Student):
S ignature of the Student Signature of the Parent
OFFICE USE - ACCOUNT SECTION
Period from____________________ to___________________
Hostel fee paid Rs.__________________ Receipt No.__________________ Date:_________________
Signature of the Accountant
Whether he / she stayed in hostel for the last Academic year____________________________ Remarks of Warden (Assessment to be made based on the conduct of last year stay of the student in hostel).
Excellent :_____________ Good :____________ Average: ____________ Poor :______________
Signature of Hostel Warden Signature of Chief Warden
Remarks of GM :
LETTER OF UNDERTAKING BY PARENT / GUARDIAN
As parent I understand the rules of GNI that my son / daughter needs to obey during the stay in the hostel.
I undertake with full understands that:
IN RESPECT OF Name :
Roll No. : Dept.:____________________________
My son / ward may be awarded punishment / penalty as deemed fit by the organization which may include expulsion / rustication from the hostel / college for the following action if found guilty as following. There will be NO REFUND in case of expulsion from hostel.
Ragging of other students.
Leaving the hostel premises without the approval of the competent college authority. The Institution / College will not be held responsible in any way if the student leaves the hostel premises without permission despite the stringent security checks in the hostel and indulge in nefarious activities.
Indulging in anti social activities of any nature (smoking, drinking, betting / gambling, drugs, quarrelling, fighting, troubling others, racism, casteism & political activities, Tarnishing image of institution in any manner etc).
Destroying / damaging the hostel / college property.
Not following the stipulated rules of the hostel laid down by the management for students, misbehaving with fellow students / warden / staff or using harsh language or disturbing others students in their studies.
Entertaining guests in the hostel / his / her room without approval of the college authorities.
No gold / huge amounts of money / expensive items (mobile phones , music system, TV etc) may be kept in the hostel room. The management will not be held responsible for theft of any item including mobiles / personal computers / any other valuables.
Activities / actions of my son / daughter outside the campus have no legal binding on the institution / college.
The management reserves the right to remove the student from the hostel on grounds of indiscipline / disobedience of hostel rules / any other ground necessitating such an action. In case of expulsion on grounds as indiscipline NO REFUND will be made.
Payment of hostel fees online / otherwise does not guarantee accommodation in the hostel. This will be strictly as per merit / hostel rules.
Opposite Gender are not permitted to visit inside hostels.
Essentials like power supply, water and Wifi are not guaranteed during Genset failure / silence hours of hostel (11.00 P.M to 05.00 AM).
Following guardians may be permitted to visit my son/ daughter during visiting hours
Name : Relation :__________________
Place :_______________________________________ Mobile :
Signature of the Student Signature of the Parent / Guardian
Date : _______________
Tags: district501506, ibrahimpatnam, 84142021202123, (095), institutions, nanak