VIVEKANANDA GIRLS HOSTEL

Plot No: 211/1905 Lewis Road Bhubaneswar

Space for Passport size photograph

HOSTEL ADMISSION FORM

1. Name of the Applicant (In capital letters) ______________________________________________ 2. Date of birth____________________ 3. Marital status (Single/Married) _____________________ 4. Occupation: ________________ 5. Blood group: __________________________________________ 6. Fathers/Husbands Name____________________________________________________ 7. Term/period of Staying From ___________________To ___________________________ 8. Address for Communication _________________________________________________ ____________________________________________________________________________ 9. Full Address of Organization: _______________________________________________ ___________________________________________________________________________
(If Student, Mention the address of Institution) 10. Present Occupation of Father/Husband (With communication address):_________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 11. Telephone Number: (Mandatory) Self Parent/Guardian Residence Office Telephone No Emergency

12. Proof of Identity._________________________________________________________________________

(PAN/Driving License/Passport/ Any other document issued by Govt to be attached)

13. Email ID: ________________________________________________________________________________ 14. Food Habit Specification: Vegetarian Non-Vegetarian

Rules and Regulation

Once occupied, resident cannot discontinue her stay for at least one year. In case of leaving hostel prior to the term, one has to give a one month notice to the in-charge or pay one month rent of the house. A student shall take due care of her belongings. No one else will be responsible for their loss and damage. Borders are directed not to allow non-boarders (family members, relatives, friends, guests etc.) Into the mess premise without due permission of authority. If outsiders are found in premise entertained by any boarder, a fine amount of Rs. 200/- shall be levied on the boarder concerned. The boarders can meet outsiders at the front office. Any deviation from this rule shall be viewed seriously. No parent or guardian of a boarder is permitted to stay in the hostel. They must obtain prior permission from Hostel In charge if any such situation arises. Hostel will be opened from 6.00 AM (Morning) to 9.00 PM (Night) each day. Lunch & Dinner shall be made available between 9AM to 1 PM & 8pm to 10 PM respectively. Boarders not willing to have any particular meal need to provide prior information of such abstinence. Residents are not allowed to stay outside the hostel overnight for their own safety. Resident willing to stay outside the hostel or taking leave can be permitted only if their parents or local guardian permission is filed or application is received in advance. Use of electrical appliances like heaters, hotplates, Gas, other objectionable/hazardous items etc. in the hostel rooms in strictly prohibited. All fans, light and electrical appliances must be switched off when not in use.
House Rent, Canteen fees need to be paid on or before 7th of every month.

Boarders having laptop can avail wifi internet service at the payment of Rs 50 per month in advance,

 Residents are not allowed to keep weapons & threatening items or any such items in their possession in the hostel premises. Possession and consumption of intoxicants and any kind of substance is strictly prohibited in the hostel premises Anyone wishing to go home need to take permission from hostel in-charge one day before. For any service, complain, suggestion and emergency, please contact:09861331788,9178189188
TIMING OF MEALS

LUNCH- 9.00AM-1.00 PM DINNER- 8.30PM-9.30PM

NOTE: There Will Be a Bell before Lunch & Dinner

Declaration: That I agree to abide by the rules & Regulation of the hostel
I am confident of my ability to work in a team. I hereby declared that the information furnished above is true to the best of my knowledge.

Full Signature of Boarders

FOR OFFICE USE ONLY 1] Security Deposit Amount: RS: 2] Room No: 3] Admit on : Bed NoValid up to Signature of Hostel I/C ( Rupees ) Date