DESH BHAGAT BOYS / GIRLS HOSTEL

(Application / Continuation Form) Students Name __________________________________________________ Affix Fathers Name ___________________________________________________ your recent two Mothers Name __________________________________________________ passport size Date of Birth ___________________________ Blood Group _____________ photographs Name of Course __________________________________________________ Name of Institution _______________________________________________ Address for Communication _________________________________________________________ __________________________________________________________________________________ Permanent Address _________________________________________________________________ __________________________________________________________________________________ City / Town _____________ Distt. _____________ State _____________ Pincode______________ Telephone (Landline) __________Mobile __________ Personal__________ Emergency__________ Declaration/Communication by the Candidates I_________________________________S/o / D/o ________________________________ have taken admission in Desh Bhagat ______________________. Please allot me a seat in the hostel for the session _______________________. I have gone through the rules and regulations of the hostel as well as those of the Institution and I undertake to abide by them. Strict disciplinary action can be taken against me in case of violation of rules on my part. I also certify that the particulars given above are true and correct to the best of my knowledge and belief. Date: ____________ __________________________ (Signature of Candidate) Medical Fitness Certificate We hereby certify that our ward ___________________________ Student of Class___________ is not suffering from any infectious disease/health disorder. In case any mishap occurs with regard to his/ her health at any time during the session, the institution/hostel authorities will not be held responsible for that. ____________________________ (Signature of Parent/ Gaurdian) Recommendation by Head of the Institution Certified that __________________________ is a bonafide student of ___________________college and is a student of ________________________Course/Year. I recommend him/her for the allotment of room in the hostel for session ____________________ subject to the availability of the seat. _____________________________ (Signature & Seal of the Principal) For Office Use Only Ms./Mr.___________________________ is allotted a room in Boys/Girls hostel No. _________ as per following details. Type of accommodation ____________________________________ Room No. _________________ Floor____________________________________________________Date of Allotment___________ Receipt No. along with date __________________________________ (Director Generals Order) ____________________ (Hostel Warden)

RULES FOR HOSTEL 1. The hostel accommodation will be given to the students on first come first basis. 2. The students will have to continue for full session who are allotted seats in the hostel. 3. The Institute will provide sharing accommodation, with cots, chairs and tables to the hostellers. However, the bedding linen, tumbler, thermos, bucket etc. will be brought by the student. The students will be responsible for the up keep of the Institute property and the articles issued for use in the hostel. Any type of damage to the property/ articles the cost will be recovered from the students. 4. The hostellers are not allowed to keep any valuable articles such as jewellery, heavy cash, expensive electrical/ electronic gadgets etc. in their rooms. The Institute under no circumstances will be responsible for any loss of any articles. However, any hostellers found to be violating the above rules will be liable for disciplinary action. 5. Consumption of alcoholic drinks, drugs, smoking and gambling etc. are prohibited. Bottles other than plastic are not allowed to be kept in the room. Objectionable materials (magazines/ cassettes/ CDs/ weapons etc.) are not allowed to be kept in the hostel room. 6. All hostellers should carry their identity cards issued by the Institute, even while going out or to the mess. During free times the students are not permitted to wander in the other parts of the Institute building. 7. Hostel students should not write anything on the walls, doors or window or cause any damage to the Institute property. Shouting/Demonstration is prohibited. 8. No electrical appliances are permitted to be used in the rooms. In case of default, the students will be liable for fine or disciplinary action as decided by the Institute Authority. 9. The hostellers will submit the form/ undertaking in duplicate duly filled in all respect along with photographs, specimen signatures of the visitors who will be unauthorized to meet the hostellers by their parents or guardians. No person other than the authorized ones will be allowed to meet the hostellers. 10. Non hostellers and guests are not allowed to visit/ stay in the boys hostel. In case any outsiders/ day scholars found visiting/ sitting in anyones room, will be liable for fines or disciplinary action as decided by the Principal/ Warden. 11. Students are required to instruct their friends and relatives not to call them on the office telephone during working hours unless in case of emergency. 12. The students are required to keep their rooms locked while going outside. The students are further required to be economical as far as possible in using the water and electricity and keep their rooms clean and tidy all the times. The hostellers are not allowed to use any type of heater/ stove/ electrical gadget/ meddle with the fitting in their rooms. 13. Ragging is not permitted. Anyone found in such activities will be liable for serve disciplinary action. 14. The hostellers are not allowed to keep any type of vehicle in the Institute. In case anybody wants to keep/ use the vehicle, he will have to take the prior permission from the Principal for the same. 15. The dinning in the Mess is compulsory for all the students residing in the Hostel accommodation. The other rules for dinning in the Mess and timing will be intimated by the Mess incharge separately. 16. The Hostellers must leave the Hostel at 9:15 a.m on working days to attend the classes & are not allowed to stay in hostel during the class hours without written permission. 17. Prior permission of the Principal/ Chief warden is required for late entry beyond 9.30 pm/ availing leave from the hostel. 18. Any change in the rule and regulation will be intimated from time to time.

__________________ Signature of Parents

__________________ Signature of Students