APPLICATION FOR HOSTEL SUBSIDY FROM GOVT. SERVANTS​.

My Child Name Ajay Kumar who is studying in

……………………………………………………………………...was admitted in hostel of School on
date………………………………… a certificate from the Principal of the school giving particulars of the
date of admission and period for which good charges are payable is enclosed. I request that the hostel
subsidy due to me on A/C of the child may be paid to me in advance each month.

2. I undertake to inform may employer forthwith if any charges in the particulars of the charge
on the period for which they are charge are effected and also in the event of my withdrawing my child
from the hostel. I also undertake to produce4 the hostel receipt for the payment of the first month
immediately after payment and thereafter at the end of every 6 months period the receipt from the hostel
for the amount paid by me during that period.

Place :…………………………
Date :…………………………

Signature of the Govt. Servant

No………………….Rank…...
Name…………………………
Place………………………….

Received a sum of Rs……………………/- (Rupees……………………………………...

…………………………………) only on account of hostel subsidy charge for the year……………...
in class………………………….to…………………………………..School of my son Name………..
…………………………………………..Rank………………….Name……………………………….

Signature of the Govt. applicant

​ATTESTED
No………………….Rank…......

Name…………………………...

Place…………………………...
 HOSTEL SUBSIDY FORM

(Name of the School and Place)

1. Name of the Boarder :………………………………………………………….

2. Father’s Name :………………………………………………………….

3. Class in which admitted :…………………………………………………………

4. Date of admission in the hostel :…………………………………………………………

5. Period during the year which :………………………………………………………...

the child would continues to
stay in the Hostel.

6. Whether Hostel is under Govt. :………………………………………………………….

of otherwise intimate Regn. No.

DETAILS
Place :………………………..

Date :………………………... ​Principal/Head Master

(With Seal)
 FORM 4
(Para 25)
HOSTEL SUBSIDY FORM

----------------------------------------------------------------- School ( Name of the School and place)

1. Name of the Boarder :………………………………………………………….

2. Father’s Name :………………………………………………………….

3. Class in which admitted :…………………………………………………………

4. Date of admission in the hostel :…………………………………………………………

5. Period during the year which :………………………………………………………...

the child would continues to
stay in the Hostel.

6. Date of Birth ……………………………………………………………………..

From To

DETAILS

(a)

(b)

(c)

(d)

Date :………………………... ​Principal/Head Master

(Stamp of the school)