83
Application form for Hostel
Stream / Faculty:
Commerce
Application Form No.
100408
Date of Submission
17 January, 2021
Personal Details
Name of Student
83
Father/Husband name
Christa
Mother name
Jenna
Date of Birth
02-11-1988
Gender
Female
Reservation Category
ST
Mobile No.
6602466773
Marital Status
Unmarried
Physically Challenged(PH)
No
Type of Disability
76
Aadhar Number
60
Email id
eritreanstungrcm@stuffedgrow.site
Permanent Address
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Course Details
Name of course
IMB
Stream / Faculty
Commerce
Class Roll Number
97
Session
2020-2023
Guardian Details
Father Photo
Mother Photo
Family Member Photo
Local Guardian Photo
Name of Family Member
Jayleene
Relation with Student
78
Name of Local Guardian
Malinda
Relation with Student
46
Address of Local Guardian
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If you use a $5 co-buy generic preferred drugs as well as a $20 co-purchase brand-name preferred drugs plus your doctor provides you with 3 months valuation on ciprofloxacin (a normal preferred drug in this example), your co-pay might be $15 ($5 for each and every 30-day supply). Listed here are a summary of just some from the medical things that Axis Medicare Ltd wish to supply you with discounted prices, given by this specific UK Online Chemists;-Children's wellness products including Bepanthen, Calpol plus Bio-Oil. Pharmacy Technician Certification Board Practice Tests.
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Is student can stay at local Guardian home or not?
no
Whether student can go to their home with local guardian during Vacation?
yes
Payment Details
Payment Status
UNPAID
नोट: बैंक स्टेटमेंट से मिलान के दरमयान UTR/Ref. Number गलत पाए जाने पर आवेदन प्रपत्र रद्द कर दिया जायेगा.
छात्रा के लिए घोषणा
मैं (नाम) 83 एतद घोषणा करती हूँ कि
1. इस आवेदन में दी गई सूचनाएँ मेरी जानकारी में सत्य है |
2. छात्रावास में निवास करने पर संयमित तथा मर्यादित आचरण करने की प्रतिज्ञा करती हूँ |
3. छात्रावास के अनुशासनिक नियमों, निर्देशों तथा अन्य अपेक्षित तथ्यों से सहमत हूँ. उसके अनुपालन में मुझसे किसी प्रकार की त्रुटि होगी तो मैं दंड की भगिनी बनूँगी |
माता/पिता के लिए घोषणा
मैं (माता/पिता का नाम) Christa एतद घोषणा करता/करती हूँ कि,
1. अपनी प्रतिपाल्या द्वारा छात्रावास के नियमों के अनुपालन तथा उसके द्वारा किये जाने वाले व्यवहारों के लिए उतरदायी रहूँगा/रहूँगी तथा उसके महाविद्यालय में होने वाले खर्च का वहन करूँगा/करुँगी |
2. जबतक मेरी प्रतिपाल्या को महविद्यालय छात्रावास में स्थान प्राप्त नहीं होता है तब तक के लिए उसके आवास की व्यवस्था में अन्यत्र करूँगा/करुँगी. मेरा स्थायी निवास इस शहर में नहीं है |