SRI RAMAKRISHNA INSTITUTE OF TECHNOLOGY, COIMBATORE-10

(Approved by AICTE, New Delhi – Affiliated to Anna University, Chennai)

Hostel Vacating form

Application No:-

Name of the student :

Name of Father/ Guardian :

Name of Mother :

Year / Branch :

Registration No : roll no.:

Gender :

Date of birth & Age :

First Graduate :

M.Q/G.Q :

Date of Vacating :

Name of hostel :

ROOM NO :

Address for communication with phone number

MOB.NO:

E-mail id :
Parent/ Guardian Phone No :

Reason for vacating the hostel

Hostel details

SEM I II III IV V VI VII VIII

Hostel no
ii/iii
Room no

Parent / guardian sign Signature of the student

SRIT- HOSTEL VACATING FORM Page 1

Details of the Furniture available in the room (STATUS GIVEN BY DEPUTY WARDEN):
COT TUBE LIGHT WITH FITTING
TABLE NIGHT LAMP WITH FITTING
CHAIR FAN WITH REGULATOR

WALL OTHERS

Call and confirm with parent Yes /no

Name and signature of the warden

Place: SRIT, COIMBATORE

Date :

Deputy Warden ASSOCIATE WARDEN chief warden

Remarks

FOR OFFICE USE ONLY

YEAR I year II year III year IV year

NAME OF THE BLOCK I / BLOCK II
BLOCK I / BLOCK BLOCK I / BLOCK II/ BLOCK I / BLOCK II/
HOSTEL
II/ BLOCK III BLOCK III BLOCK III

Room number
HOSTEL MESS HOSTEL MESS HOSTEL MESS HOSTEL MESS
FEE FEE FEE FEE FEE FEE FEE FEE
Bill no

FEE ACTUAL
DETAILS FEE
FEE PAID

REMARKS

FINE AMOUNT

SIGNATURE WITH DATE

*(Attach a Copy of Hostel Fees receipt)

SRIT- HOSTEL VACATING FORM Page 2