HOSTEL
ADMISSION FORM
Session 2008-2009
The Directror,
South Delhi Polytechnic for Women,
New Delhi
I the undersigned hereby apply for Admission to the Polytechnic Hostel, subject
to all its Rule and Regulations that may be
applicable to me from time to time.
1. Name(In block letters)..................................................................Marital Status - Single/Married/ Widow/ Separated
2. Mother’s name ............................................................................Occupation ..................................................................
3. Father's Name.............................................................................Occupation
..................................................................
(If business give details)
......................................................................................................................................................
4. Guardian’s Name
.......................................................................Occupation
..................................................................
(If any )
5. Local Guardian in
Delhi....................................................................................................................................................
6. Address ........................................................................................... Phone: ...................................................................
7. Local Guardian in Delhi.......................................................................................................................................................
8. Address ............................................................................................Phone( Mobile): .......................................................
9. Whom to contact in an Emergency......................................................................................................................................
10. Course in Which Admission is sought................................................................................................................................
11. Vegetarian/ Non-Vegetarian,(Vegetarian with Eggs)
I hereby certify that I have read all the Rules and Regulations about the Hostel, particularly those regarding going to the Market, Movies, Local Guardians place or seeing Visitors. I shall abide by all of them.
Signature
of Applicant
I certify that my Ward will pay the full Hostel Dues in advance. She will abide
by the Rules and Regulations of the Polytechnic
Hostel that may be in force from time to time.
Signature of Applicant Signature of Parent/Guardian
Date:
UNDERTAKING
This is to affirm that I have read and understood the Rules and Regulations of the Polytechnic and I shall abide by them. I also understand that all amounts including Hostel Charges shall not be refunded to me by the Polytechnic. This is regardless of whether I join or do not join the Hostel after seeking admission or discontinue during the Term.
Signature of Parents
Signature
of Applicant
Date:
Date:
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