PLATINUM BOYS HOSTEL

Admission Form
1.
2.
3.
4.
5.
6.
7.
8.

All disputes are subject to kota Jurisdiction.

Please rad the application form together with hostel rules and regulation attached here with
carefully before filling this form.
Please fill in all the required information correctly in neat handwriting in capital letters.
Giving false or misleading information would lead to cancellation of
admission/rejection of application form as the case may be.
Room No
Incomplete form or unsigned form will be rejected.
For admission in the hostel, management decision would be final.
Duration of Stay
Duration of stay should be minimum of 10 months.
The application form should be supported with one set of attested photocopy of marksheet/certificate of last
examination, school/coaching institute admission proof & ID proof of parents.
Date of joining..

Electricity Meter Reading

STUDENT PERSONAL INFORMATION

A.

FULL NAME... DATE OF BIRTH

B.

NAME OF COACHING INSTITUTE..

C.

PREPARING FOR COURSE IIT ADVANCE

D.

MOBILE NO.

E.

CLASS PASSED/APPEARED CGPA/PERCENTAGE OBTAINED

F.

SCHOOLING IN KOTA: YES/NO (IF YES THEN NAME OF SCHOOL)

IIT MAINS

MEDICAL

OTHERS

PARENTS DATA
A.

FATHERS NAMEMOTHERS NAME

B.

OCCUPTION

C.

CONTACT NO. (FATHER)(MOTHER)..

D.

PERMANENT ADDRESS

LOCAL GUARDIANTS (IF ANY)

A. FULL NAME .MOB NO.
B. POSTAL ADDRESS.
RELATION WITH SCHOLAR.

Signature of Student

Signature of Parents/guardian

HOSTELS RULES & REGULATIONS

1. One month rent has to be paid in advance along with security deposit.

2. Electricity bill will be charged extra as per individual room-wise meter installed.
3. Security deposit has to be deposited at the time of admission, which will be refunded only if the period of
stay in the hostel is minimum for 10 month.
4. Room rent will be charged for at least 10 month ,irrespective of the duration of course offered by any
institution.
5. Any damages to the hostel property or any graffiti/posters/stickers etc applied to the walls or any damage
will attract deductions from security deposit.
6. The payment of rent is to be mad up to 5th of every month in case or cheque. In case the payment is
delayed R s200/- will be charge per day as late fee. If the rent is not recovered by 10 th of every month,
the management may ask the student to vacate the room without refunding the security deposit .
7. Rent will be charged for whole month including mess facility, In case the student doesnt want to avail
mess facility ,no rebate will be given.
8. Hostel management reserve the right to revise the room rent from 31 st march every year.
9. Hostel management is not responsible for any loss or theft done by your friends, co-residents, staff in the
hostel and advises you to lock the room & is not responsible for damages or loss of clothes by
unintentional mistake by the washerman.
10. Hostel management is not responsible for any loss of bicycle, cash, valuables or any other
loss/dispute/food poisoning/stress related incidence/accident/miss happening/natural calamities (earth
quake,flood/lightening) or any other personal act inside or outside the hostel premises.
11. Hostel management advises the student to get their room cleaned in their presence only. In no case room
keys should be given to any hostel staff.
12. Hostel management has the right to shift any student from one room to another any time as per
requirement and can inspect room any time they want.Disturbance wil not be claimed as a reason for
argue as managment will always try to maintain peace and clam environment in the hostel for studying.
13. Change of room by student can be done on request subject to availibilty & management will always try to
maintain peace and calm environment in the hostel for studying.
14. Service tax & any other tax levied by government on rent on any services frm time to time wil be payable
by students.
15. All fixtures in the room like walls,windows,doors,furniture etc. should be kept in good condition .No nailing
or posters on the walls are allowed & if found guilty student will be charged for the renovation.
16. Student have to mark in out entry in register kept at main gate every time they enter or leave the hostel.
Daily attendance will be carried out after 10:00 pm by the hostel staff.
17. Hostel timings Morning 06:00 am to 10:00pm .Students will not be allowed to enter the hostel after 10:00
pm in the night.
18. FOOD : No food item frm the mess,cafeteria or elsewhere are to be carried to the room
.fruits,nuts,sprouts,biscuits and pre packed bakery and confectioneries can be kept in the
rooms.However,their consumptions should be in such a way which does not effect the cleanliness of the
hostel .
19. Wastage of utilities: Occupation should be judicious in proper use of amenities provided (water &
Electricity). They are required to switch off lights fans every time leave the room.High voltage electric
equipments & radio,laptop etc are not to be used in hostel rooms. If found scholars will face confiscation
of the item and deterrent fines of Rs 1000.

20. Movement of occupants and outsiders: Scholars access to hostel terrance is barred and no
friend/relatives are allowed inside the hostel.
21. Act/Deeds outside the Hostel Premises: It should be noted that the hostel management would not be
responsible for any act, deed, accident or miss-happening done by or caused to scholar outside the
hostel premises.
22. Consumptions of alcoholic drinks and smoking is strictly prohibited,Schlors entering the hostel in an
inebriated condition will have to face stem disciplinary action,if found in possession of
liquor,drugs,spirit,cigrattes,beedies or gutkha etc.will be rusticated immediately. Celebration of birthday
party and other festivals in hostel is strictly prohibited.
23. Scholars are binded to follow the rules & regulations and if not they can be asked to vacate the room
immediately without any pre warning and security deposit will be forfeited by hostel management
24. This hostel is a quite zone. You are in kota to fulfill your ambition.The hostel staff will be happy to help in
fulfilling your ambitions
Signature of Student

Signature of Parents/Guardian

Date.

I assent to the above applications and solemnly declare that the entries written
Dateddtygdddddd
by me/my son/ward
are true. I guarantee that he will abide by the official rules,
regulation and notifications of the hostel. I have read and I agree to the hostels
rules & regulations

Name of
Father

Full postal Address

..
Mob No.

AFFIDAVIT
Affidavit
I

(Parents name)
Son of/Wife of Sh./Smtage about ..years
resident of

(Permanent Address)
Do hereby solemnly declare that:

1. That I am parent
ofand I
have admitted my
Son in

.
(Hostel name & address)
For residence, for a minimum duration of 10 months in one academic year.
2.

That I also declare that if my son vacates the room for any reason before 10 months, I will
not be entitled for
Refund of security deposit

3.

That I also declare that if my son is involved in any illegal activities or violation of any
rules and regulations of the hostel, hostel management has right to get the room vacated
at that time and forfeit all the security deposit.

Date..
Signature of Parents/Guardian