HIMACHAL PRADESH UNIVERSITY

Size: px

Start display at page:

Download "HIMACHAL PRADESH UNIVERSITY"

Robyn Austin
5 years ago
Views:

1 HIMACHAL PRADESH UNIVERSITY HOSTEL ADMISSION FORM (To be submitted in duplicate) Diary No.... Dated :... Note: Please tick ( ) the category in which applying (HPU/ Non-HPU/SC/ST/Cultural/Phy. Handicapped) 1. Name of the Applicant (in block Letters) 2. Father s Name 3. Date of Birth 4. Do you belong to SC/ST 5. Department 6. Class Semester Class Roll No. 7. HPU Registration No. 8. In case of Ph. D. Date of Enrolment (attach photocopy) 9. (i) Nationality (ii) Your Adhaar Card No. 10. Mobile No. (Self) (Father s) 11. Correspondence Address Telephone No. (with code) Office Residence 12. Permanent Home Address Telephone No. (with code) Parents Mobile No. (Please attach Domicile Certificate) 13. Name and Address of the Local Guardian (person to be contacted in case of emergency) _ (a) Relationship with Local Guardian (b) Phone No. (Residence) Mobile No. 14. Were you resident of H.P. University Hostel earlier? Yes/No If yes give particulars: Name of the Hostel Room No. Year(s) of stay Department Course 15. Were you ever punished for Misconduct/Violation of Hostel Rules/ Indiscipline, etc. Yes/No. If yes give details 1. Paste Passport size photograph has duly attested by the Chairman.

2 -2- DECLARATION I hereby declare that I have gone through and noted the hostel rules and regulations given in the Handbook of Information and understood that strict conformity to this is an express condition for my admission as boarder in the hostel. I further declare that I am a student of day classes of the Department concerned. In case I cease to be a student of day classes, I shall inform the Warden about my changed status immediately and leave the hostel as required under the rules. Further, I will not allow anybody to stay as guest in my room without prior permission of the Warden and I shall pay my mess dues every month regularly. In case, some illegal/unauthorized person is found in my room at any stage, I shall be liable to be punished as per the hostel rules including cancellation of my admission in the hostel as well as from the department concerned for this lapse. Moreover, I will not indulge in any act of Ragging, Indiscipline, Misconduct, political and unlawful activities and if I am found guilty of such offence, I will have no claim against the expulsion/rustication from the hostel in compliance to the recommendations of the Supreme Court of India in SLP NO of 2006 (Reghvan Committee s Report). I have attached necessary Affidavit duly attested by the Notary as per specimen available below the important instructions. Dated Signature of the Applicant (TO BE FILLED IN BY THE DEPARTMENT CONCERNED) This is certified that Mr./Miss has been admitted in the Department of...class... Semester... on the basis of merit under... category and his/her final score (on the basis of which admission has been sought in the department) is... He/She is a regular student of this department in the day classes and has deposited his/her department fees vide receipt No....dated... for the current quarter ending His/her name is recommended for admission to the hostel. It is further certified that the merit given above is the same as from the basis for admission in the Department/Course. Category Final Score on the basis of which admission is made in the department... Chairperson of the Department (with office seal) Note: No Evening College Classes Student/Employee/ICDEOL/local student is eligible for admission in University Hostel. FOR USE IN WARDEN/CHIEF WARDEN OFFICE Recommended/Not Recommended Room No. Allotted Admitted Warden H.P. University Boys/Girls Hostel Mess Security Receipt No. dated Signature of Mess Clerk Warden TO BE FILLED IN BY THE CHIEF WARDEN S OFFICE Hostel s dues/securities of Rs. realized vide Receipt No. dated Section Officer Signature of Hostel Dealing Assistant

3 -3- HIMACHAL PRADESH UNIVERSITY HOSTEL ADMISSION FORM (To be submitted in duplicate) Diary No.... Dated :... Note: Please tick ( ) the category in which applying (HPU/ Non-HPU/SC/ST/Cultural/Phy. Handicapped) 1. Name of the Applicant (in block Letters) 2. Father s Name 3. Date of Birth 4. Do you belong to SC/ST 5. Department 6. Class Semester Class Roll No. 7. HPU Registration No. 8. In case of Ph. D. Date of Enrolment (attach photocopy) 9. (i) Nationality (ii) Your Adhaar Card No. 10. Mobile No. (Self) (Father s) 11. Correspondence Address Telephone No. (with code) Office Residence 12. Permanent Home Address Telephone No. (with code) Parents Mobile No. (Please attach Domicile Certificate) 13. Name and Address of the Local Guardian (person to be contacted in case of emergency) _ (c) Relationship with Local Guardian (d) Phone No. (Residence) Mobile No. 14. Were you resident of H.P. University Hostel earlier? Yes/No If yes give particulars: Name of the Hostel Room No. Year(s) of stay Department Course 15. Were you ever punished for Misconduct/Violation of Hostel Rules/ Indiscipline, etc. Yes/No. If yes give details 1. Paste Passport size photograph has duly attested by the Chairman.

4 -4- DECLARATION I hereby declare that I have gone through and noted the hostel rules and regulations given in the Handbook of Information and understood that strict conformity to this is an express condition for my admission as boarder in the hostel. I further declare that I am a student of day classes of the Department concerned. In case I cease to be a student of day classes, I shall inform the Warden about my changed status immediately and leave the hostel as required under the rules. Further, I will not allow anybody to stay as guest in my room without prior permission of the Warden and I shall pay my mess dues every month regularly. In case, some illegal/unauthorized person is found in my room at any stage, I shall be liable to be punished as per the hostel rules including cancellation of my admission in the hostel as well as from the department concerned for this lapse. Moreover, I will not indulge in any act of Ragging, Indiscipline, Misconduct, political and unlawful activities and if I am found guilty of such offence, I will have no claim against the expulsion/rustication from the hostel in compliance to the recommendations of the Supreme Court of India in SLP NO of 2006 (Reghvan Committee s Report). I have attached necessary Affidavit duly attested by the Notary as per specimen available below the important instructions. Dated Signature of the Applicant (TO BE FILLED IN BY THE DEPARTMENT CONCERNED) This is certified that Mr./Miss has been admitted in the Department of...class... Semester... on the basis of merit under... category and his/her final score (on the basis of which admission has been sought in the department) is... He/She is a regular student of this department in the day classes and has deposited his/her department fees vide receipt No....dated... for the current quarter ending His/her name is recommended for admission to the hostel. It is further certified that the merit given above is the same as from the basis for admission in the Department/Course. Category Final Score on the basis of which admission is made in the department... Chairperson of the Department (with office seal) Note: No Evening College Classes Student/Employee/ICDEOL/local student is eligible for admission in University Hostel. FOR USE IN WARDEN/CHIEF WARDEN OFFICE Recommended/Not Recommended Room No. Allotted Admitted Warden H.P. University Boys/Girls Hostel Mess Security Receipt No. dated Signature of Mess Clerk Warden TO BE FILLED IN BY THE CHIEF WARDEN S OFFICE Hostel s dues/securities of Rs. realized vide Receipt No. dated Section Officer Signature of Hostel Dealing Assistant

5 -6- UNDERTAKING I do hereby solemnly affirm and declare that I shall abide by the provision contained in the H.P. University Act, Statutes, Ordinances, Hostel Rules and Regulations as provided in the Hand Book of Information amended from time to time. I further undertake not to participate in any political and other unlawful activities including ragging which harm the social, academic and congenial environment of the hostel. In case of any breach of trust and undertaking I shall be liable for punishment as per rules and regulations including cancellation of my admission from the hostel without any notice and also recovery of damages, if any, from me. Dated: Place: ( ) Name and Signature of the Candidate Address UNDERTAKING I do hereby solemnly declare/ undertake that my ward Mr. /Ms. shall abide by the provisions contained in the H.P. University Act, Statute, Ordinances and Hostel Rules and Regulations provided in the Hand Book of Information as amended from time to time. My ward shall not participate in any political and other unlawful activities including ragging which harm the social, academic atmosphere, create indiscipline and spoil congenial environment of the hostel. In case my ward indulge in any of such activities at any stage he/she shall be liable to be punished as per rules and regulation. His/Her admission to the hostel may be cancelled without any notice and damages, if any, shall be recovered from him/her. ( ) Name and Signature of the Parent/Guardian Dated: Place: Address Telephone No. with code

6 (SELF DECLARATION) I S/o/D/o Sh. aged years, resident of Hostel do hereby solemnly declare that I shall not indulge in any act of indiscipline, personal or group clashes, violence and political activities. In case I am found indulged in above mentioned activities, strict disciplinary action may be initiated against me, which includes expulsion from the hostel as well as from the University. Place: Dated: (Signature of the Applicant) Full Name Hostel Room No. Tel/Mobile No.

NOTICE ALL INDIA SHRI SHIVAJI MEMORIAL SOCIETY'S SHIVAJI NAGAR LADIES / PARVATI LADIES AND BOYS HOSTEL

NOTICE ALL INDIA SHRI SHIVAJI MEMORIAL SOCIETY'S SHIVAJI NAGAR LADIES / PARVATI LADIES AND BOYS HOSTEL GENERAL INFORMATION FOR THE YEAR 2018-19 1. Fees : Rs. 43,200/- Per Academic Year 2. Mess Fees : Rs.4,600/-