HOSTEL ADMISSION APPLICATION FORM FOR THE YEAR

Transcription

1 Office/14-15 SRI SATHYA SAI HOSTEL SRI SATHYA SAI INSTITUTE OF HIGHER LEARNING MUDDENAHALLI CAMPUS, SATHYASAI GRAMA MUDDENAHALLI, CHICKBALLAPUR (Profile Form for I year under graduate students in Muddenahalli, ) Application/ Regd.No HOSTEL ADMISSION APPLICATION FORM FOR THE YEAR Name of Student (In Capital Letters) 02 Date of Birth 03 Class Admitted to: 04 Blood Group: Affix your recent colour passport size photograph (in white dress) 05 Name of Parent/Guardian (In Capital Letters) 06 Address for Communication 07 Contact Details Pin Code: Phone No. : (with STD code) Mobile No.: ID: 08 Profession of Parent/Guardian: (with full details) 09 Annual Income of Parent/Guardian 10 Name of relatives who may have already studied or studying in our Institute/Schools Page 1 of 4

2 11 Local Guardian s Name, Address and Contact details with phone number (if any) 12. Number of years stayed in SRI SATHYA SAI HOSTELS(S): Yes/ No (If Yes) S.S.S Primary School S.S.S.H.S School Any other Sai School (Alike, Muddenahalli,) Total Years of Stay 13. Academic Record while studying in School: Percent Obtained X XI XII Annual (%) 14. Academic Distinctions / Medals received in the past: Yes / No (Give Details if any) 15. Exposure to Bal Vikas / EHV / Pre-Seva Dal / Seva Dal: Yes / No (Mention work in any other spiritual / Service organization, NGO if any) 16. Write briefly, your opinion of the development that has been taken place in your personality during your stay in Bhagavan s Hostel(s) / Bal Vikas / EHV / Pre-Seva Dal / Seva Dal 17. Brothers / Sisters (including cousins), studied in Sri Sathya Sai Institutions: Yes / No (If Yes) Name Institution Pla ce Course Period of Study Relationship Page 2 of 4

3 18. Any Chronic Ailment? Yes / No (If Yes), Please furnish details (Asthma / Spinal Ailment / Migraine / Any Other) 19. Extra Curricular Activities which you have been associated:.. (N.C.C. / N.S.S / Yoga / Photography / Actor / Debates / Music / Dance / Vedam student) 20. State at least two aspects of personality where you wish to improve with regard to your character building. 21. List your Hobbies in the order of priority: 22. Games and Sports (Specialisation if any): 23. Prizes won during the recent Sports / Cultural meet of your school: EVENT PRIZE YEAR OF WINNING Page 3 of 4

4 DECLARATION BY THE PARENT / GUARDIAN I give my consent to my ward to join and reside at Sri Sathya Sai Hostel, Muddenahalli during the course of his study at Sri Sathya Sai Institute of Higher Learning, Muddenahalli campus, after having read and fully understood the type of education imparted, rules and regulations that are followed. He will adapt himself to the lifestyle which is being followed here and will not indulge in any act of indiscipline, misbehavior or unethical activities, but up hold the dignity and cultural sentiments of the Hostel and Institute. I am also aware that, in the event of my ward not adhering to discipline of the Hostel by violating the code of conduct expected of him at any time during the period of his study, he shall forfeit his admission to the degree. In such circumstances, I will immediately arrange to withdraw my ward from the Institute and the Hostel failing which the Hostel can take suitable steps to send him back. I hope and pray that my ward adequately uses the opportunity given to him by SSSIHL Institution to shape his personality. Place: Date: Signature of the Parent / Guardian: DECLARATION BY THE STUDENT I declare that I am joining the Sri Sathya Sai Hostel, Muddenahalli after knowing fully well about the rules & regulations and other information pertaining to my stay. I have prepared myself accordingly and will follow the codes of conduct and practices of the Hostel and Institute. I shall conduct myself responsibly as a Sai Student by following the discipline and through my attitude, commitment and involvement, constructively contribute to all routine and developmental activities of the system. I will not indulge in any act of indiscipline during the entire period of my stay in this Hostel. I am also aware that in the event of my not adhering to the discipline of the Hostel by violating the rules, I will have to forfeit my admission, and will also be removed from the Hostel immediately. Place: Date: Signature of the Student Page 4 of 4

5 SRI SATHYA SAI HOSTEL, SSSIHL, MUDDENAHALLI Procedure for Admission into Hostel and Information for New Entrants 31 st May Sri Sathya Sai Hostel is a loving home granted by Bhagawan Baba to His students for their spiritual and all round growth. All students must use their precious years of stay in the Hostel for that purpose. 2. All students must be accompanied by their parent(s) on the day of admission. Those students who are not survived by parent(s) may be accompanied by their Guardian(s). 3. The students must fill up the hostel application form on arrival at the hostel and sign the same. The application form along with the declaration form regarding hostel disciplinary regulations will have to be countersigned by the parent or guardian in charge. 4. HOSTEL CHARGES: The student will have to pay the boarding charges of Rs.15,000 and a caution deposit of Rs. 1,500 totaling to Rs.16,500, in one installment at the time of joining the Hostel. The caution deposit is refundable as and when the student leaves the Institute. 5. The hostel charges may be paid by the following modes: a) The amount may be paid online by remitting the same to the hostel account with State Bank of India, Chickballapur, as per details given below: Account no. : IFSC: SBIIN Branch Code: 7908 VERY IMPORTANT POINT TO BE NOTED FOR ONLINE TRANSACTION: All those who are making online payment of hostel charges, must necessarily submit the stamped counterfoil of the credit slip OR any such other proof/bank acknowledgement to the office during admission. Any charges for online transfer must be borne by the applicant. b) The amount may be paid by Demand Draft. DD should be drawn in favour of: SRI SATHYA SAI SOCIETY FOR SSSIHL HOSTEL, MUDDENAHALLI DD should be drawn on: STATE BANK OF INDIA, CHICKBALLAPUR. Branch Code: 7908 The Hostel adopts a dividing system of accounting, which facilitates equal division of hostel expenditure among all the residents. Deficit if any will be charged at the end of the semester. 1

6 6. Every student must equip himself with the following essential items at the time of joining the hostel: a) At least four (4) pairs of white dresses b) 2 3 pairs of sober coloured dresses of appropriate length (Bermudas and shorts are not allowed) c) Two sets of track suits d) Bedding with blanket and bed spreads e) Bucket and Mug f) Plate, tumbler and spoon g) A pair of sports shoes (Canvas or any other type) h) Warm clothing like sweater, shawl etc., for the winter. Students can procure the above items from the general stores inside the campus also. 7. Students must submit twelve (12) recent passport size and twelve (12) stamp size photographs taken in formal white dress, with well-groomed hair, short sideburns, and clean shaven face. Photographs in colour dress will not be accepted. The photographs will be used for the records of the University, Hostel and bank. 8. Admission to the Hostel is provisional until the student undergoes a medical examination conducted by the Hostel doctor. Any history of chronic ailments should be mentioned in the Student's Health Record provided. Admission to the Hostel will be confirmed only after certification by the doctor. ******* 2