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School of Technology Gandhinagar

Pandit Deendayal Petroleum University


SOT Library and Information Centre
Application form for availing Text Books from Book Bank

1. Name of Student :
2. Roll No :

3. Discipline :
4. Semester :

5. Residence Address with :


Telephone No.

6. Occupation of Father/Guardian:

7. Annual Income of Family :


(Copy of the salary certificate PLC A/C Balance Sheet & Income tax Assessment order of
(parents/guardian to be attached)

8. Result of the examination Attempted (with percentage)

[A] 1.SSCE -Total Marks ________Marks Obtained _______ Percentage ______

2. HSCE–Total Marks ________Marks Obtained _______ Percentage ______

[b] Term End / Sessional Exam

SC ST
9. Whether Belongs to SC/ST :
(If ‘Yes’, attach Certificate)

-----------------------------
Signature of Student

10. Remarks and Signature of Librarian:

Date:
Undertakings:

I,___________________________________, Hereby undertake that if I am given text books form


the Book Bank, I Shall use the same with utmost care: That I Shall return the books as soon as the
Semester end exams are over or even earlier if I am asked to do so and that I shall abide by the
Rules of the Book Bank.

Place Signature of Student

Date:

Conditions:

1. The Book will be given to the students of all the categories on the basis of the income of their
parents and the ceiling of the same will be Rupees 2 lacks per annum.
2. Depending upon the availability of the sets of books the priority will be given to the students
whose parent’s income is below the Rs. 2 lacks per annuam.
3. All students who are availing the facility must ensure retuning the entire set of books provided
to them within two days of completion of their final examination in the concerned Semester.

4. If any student availing the facility loses the book / damages the book / disfigures the book, he /
she shall replace the volume(s) with new book (or pay the current cost of the book plus fine, if
any, as may be directed by authority).