APPLICATION FOR ADMISSION INTO GOVERNMENT BOYS / GIRLS HOSTEL FRESH / RENEWAL 1. Name of the Applicant (in CAPITALS) : 2. (a) Date of Birth and Age : (Enclose attested copy of certificate) (b) Sex : 3. (a) Father / Guardian.s Name : (b) Father.s Occupation : (c) Annual Income of Family (Certificate : Rs. obtained from Department of Revenue should be enclosed) 4. Address for Correspondence : (With Telephone Number) PIN Code 5. Permanent Address : PIN Code 6. Community : Scheduled Caste : Sub Caste : Other Economically : Sub Caste : Backward Class 7. State Whether Resident of Jammu and Kashmir?: Yes / No (If Yes, attach Residence and Nativity Certificate) Date Month Year Age : Male / Female 8. (a) Name of the School / College now : studying (b) Class / Course : ................. Year ............... Affix passport size photograph duly attested by a Gazetted Officer and attach 3 additional copies of the same photographs. (c) Distance of School / College from : ................. Kms. place of Residence 9. (a) Whether the applicant was an inmate : Yes / No of AWD.s Hostel previously ? (b) If Yes, (i) Name of Hostel : (ii) Course / Class : (iii) Year of Study : (iv) Whether Promoted or : Detained 10. Furnish the details of Class / Course : Class ................. Course ................. last studied (Attested copy of Transfer Certificate obtained from Institution last studied should be enclosed) DECLARATION I hereby declare that particulars furnished above in the application are true and correct to the best of my knowledge and belief. I fully understand that in the event of any information being found false and incorrect, my application shall be liable for rejection and I am liable for expulsion from Hostel forthwith. I also declare that I will abide by the Rules and Regulations laid by the Department pertaining to hostel admission. Signature of Applicant Place : Date : Signature of Parent
