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GHS

wiut Swe

Hostel Allocation Form


Student Information
Student Name

Reg ID
xahil Cralasp0.0805 112003
Gender le
214o3oo
Application no.2 19403e0 Year
2221-2022
Branch
B.Te mekatuen ourse
Email Mhdnonis eng
Mobile No.
8140392350 |Id daxshilgalaBya@al.eb
Name
Parent/Guardian Information
Ha. Digeah Galassa Relationship Fatha
Occupation
Mobile No. Susina Email Id
Injo@acebxasa. Lom
975341350 Residence No.

Permanent Address

Address Line 49.Dsuy


PloE
Address Line 2

City Sbildlng
Pin Code
Namnapas State
Cuuiarak
361 oo5 Country Inola
Ihereby confirm acceptance that I have read and
understand the below documents: Student's Sign Parent's Sign-
Student Undertaking p i dm Gulg
Hostel Rules and Regulations
Hostel inventory form (ltems in the room as per
RAxhi 9ulalys
list on next page)

Fee details
Order 1D 3849 Date 16 -lo 2 02
-
Amount ||1,60, 880.co

Key issued by
Student's signature laxshil 0.
aladp
GHS

Residents/ students must acknowledge the below points


Students are strongly advised not to share the room keys with anyone which may be misused
later
.The residents/student shall be solely responsible for the missing
keys
Duplication of the room keys is not permitted and if any student found making a duplicate key
will be heavily penalized and may lead to disciplinary action
Residents/Students agree to submit their room keys to the respective caretaker after the
completion of academic year. In the event of failing to deposit the keys student will be liable
to pay the fine of Rs. 920 per day.

Please use blue pen only and scan the document in colour before
uploading.

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