EDO STATE

COLLEGE OF NURSING SCIENCES

Knowledge for Service
HOSTEL CLEARANCE FORM
ACADEMIC YEAR 20__ -- 20__
(Please fill in the form in block letters)
Name:
………………………………………………………………………….
(Surname first)
PASSPORT
Matric No: …………………………………... Sex: ……………… PHOTOGRAPH

Dept: ………………………… Level: ……………. Date of Birth:

……………………

Religion: ……………………………... Tel No:

………………………………………………...

Email: …………………………………………………………………………………………………...

Home Address: ………………………………………………………………………………………

….…………………………………………………………………………………………………………..

Medical Illness (If any): …………………………………………………………………………………

PERSON TO CONTACT IN CASE OF EMERGENCY

Name: ……………………………………………………. Relationship: ………………...

Home Address: ……………………………………………………………………………………….
….…………………………………………………………………………………………………………...

Email: ………………………………………………………… Tel No: ………………………...

DECLARATION
1. I declare that the particulars in this application form are true to the best of my knowledge and
I have not willfully suppressed any information or facts. Any misinterpretation or omission of
information will render me ineligible for student accommodation.
2. I confirm and agree that I have read the rules and regulation of the Hostel
3. I agree that I will not take any action against the college if I am found guilty.

Signature: ………………………... Date: ………………….

NOTE: ACCOMODATION DOES NOT INCLUDE STUDENT FEEDING
 RESIDENTS CAN COME WITH PLAIN COLOURED BEDSHEET

HOSTEL RULES AND REGULATIONS

1. On acceptance into the hostel room, student will obey the rules and regulations of the hostel.
2. All residents are required to carry their valid identity card issued to them by the college.
3. The school authority does not accept any responsibilities for the loss or damage of student’s
personal belongings.
4. Residents must ensure that the doors are locked and all electrical switches are switched off
when not in use. The college will be responsible for replacing electrical bulbs.
5. Rooms are to be kept clean and tidy with beds properly made by the occupying students.
6. No liquid or water must be emptied through the windows into the surrounding environment.
7. Musical instruments should not be played after 8 PM in any case, at no time may they be use
d to the disturbance or annoyance of other residents.
8. It is unethical and therefore unacceptable for students to shout through windows to passers-b
y or to conduct themselves in a manner likely to cause a breach of the peace.
9. Students are not allowed to host any visitor/visitors in their rooms
10. Visitors are not to be received at the hostel gate or anywhere around premises except in the
common room.
11. Students are responsible for the care of the furniture and equipment provided in their rooms
and hostels. A student or group of students who damage hostel property would be held accounta
ble, and to replace such items.
12. Visiting time is every day –
(a) Monday – Friday = 4:30pm - 6:30pm
(b) Saturday – Sunday 2:00pm - 6:30pm
13. Any student requesting a late pass must apply in duplicate to the Management through the
Hostel Manager not later than 9 a.m. on the day. Anyone on late pass must be back to the hostel
not later than 8pm.. This privilege may not be given more than twice a month.
14. Students are permitted to go out after school hours or when off duty, but must be back to the
hostel, latest 8p.m. of the same day.
15. Any student wishing to travel out of the hostel during his/her night off must apply in duplica
te to the Management through the Hostel Management not later than 9 a.m. on that day.
16. No cooking in hostel rooms
17. Use of electric cooker and boiling rings are strictly prohibited. Defaulters will be liable
to suspension as first offence and dismissal thereafter. Candles must not be used in the hos
tel
18. No visitor is to pass the night in the hostel room with any student. Private arrangement shou
ld be made for any visitor.
19. No student is permitted to issue threats to a fellow student. Any act of threat to kill or injure
is punishable by dismissal from the school if such threats are confirmed by at least two witnesse
s. Any student travelling must sign out and give a specific address as to where she can be traced
when necessary.
20. Laundry: Students are individually responsible for the laundering of all linens as used by e
ach of them. Hanging of clothes on hand rails or around the hostel premises is prohibited, excep
t on the lines provided.
21. Fighting: A student or group of students who engage themselves in fighting will be dismiss
ed. Any student who is highly provoked by another student should make such report in writings
through the Hostel Manager for necessary action.
22. No liquid or water must be emptied through the windows into the surrounding environment.
23. Musical instruments should not be played after 8p.m. in any case, at no time may they be us
ed to the disturbance or annoyance of other residents.
24. Residents are not permitted to give their hostel keys to any other person to use while they
are away.
25. Smoking, consumption of alcohol and drugs are strictly not allowed within the hostel
premises.
26. Vandalism or removing hostel/college property is very serious offence. Residents found
guilty can or will be evicted from the residence. The cost of making good and items vandalized
will be charged accordingly to the resident.
27. Gambling / gaming which involves betting is strictly not allowed in the hostel premises.
28. Viewing, possession and / or dissemination of pornographic materials is strictly prohibited.
29. Residents found causing embarrassment, unsolicited compliments, sexually tainted jokes,
spreading false rumors will be evicted from the residence.
30. Fighting or physical violence is not allowed. Residents found committing such offence will
be evicted.
31. The college reserves the right for it designates to enter and inspect a residence in the
interests of safety and proper conduct of the students. Entry can be made at any time, whether
or not the students are present, and without the prior notice to the students.
32. No hawkers are allowed in the hostel or allowed to enter the rooms.
33. Roll call is 8pm and all residents must be found in their hostel rooms. Anybody absent for
more than 3times, will be expel from the hostel
34. The student lounge is locked by 7:45pm

FOR OFFICIAL USE ONLY

Date of Admission in the Hostel: …………………... Room Allocated: ……………………

….……………………………………. ………………………..
Hostel Manager Registrar