KIT's BOY's HOSTEL ADMISSION FORM

To,
The Principal,

College Of Engg./Institute of
Managment Education and Research
Gokul Shirgaon, Kolhapur - 416234

Respected Sir/Madam,

I Mr, request for admission in KIT's Boys Hostel. My Roll No. and am studying in .

I have read all the rules of the hostel and shall follow and abide by them curing my stay. I fully know that anu breach of the rules and any

unlowered behaviour on my part will immediately result in cancellation of my admission in hostel and I shall have to vacate. MY parents

have given me permission to reside in the hostel. It in binding on me to pay the hostel and mess charges regularly. I solemnly declare that

information given below is correct.

PLACE :

DATE : (dd) (mm) (yyyy)

Personal Details

Last name: Middle Name: First name: Caste: Religion:

Birth Date: (dd) (mm) (yyyy) E-mail: Class: Branch:

Roll No: Any Major Previous Disease/Surgery: Blood Grp: Last Exam:

Marks obtained: Last educational instituion attended: Favourite Game:1) 2)

Vehicle No.(if possesing): Parent's Annual Income: Guardian's name:

Guardian's Profession: Permanent Address: Local Address: Contact NO:

Reciept No: Amount Paid: Amount Left: Room no:

Undertaking to be given by student

I, the undersigned Mr. Student of KIT's college of Engg./ Institue of Managment Education & Research, Class

Branch Roll No. h erewith agree to comply with all the rules and regulations of the hostel and also make

good any loss or damage to KIT's property etc. Incurred through any misbehaviour or negligence an my part. I have read the rules and

regulations and have clearly understood them. I will abide by all the rules and regulations in force and any changes made to the rules from

time to time.

Accepted: Date: (dd) (mm) (yyyy)