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INTERNATIONAL WOMEN POLYTECHNIC
Under the aegis of KLGR Educational Society

HOSTEL ADMISSION FORM

 

Photograph

of

Applicant
The Director,
International Women Polytechnic,
A – 1/28, Janakpuri, Main Najafgarh Road,
Opp. Metro Pillar No. 626, New Delhi - 58.

I, The undersigned hereby apply for admission in IWP Hostel.
Name (in block letters) Miss/ Mrs ..........................................................................................................
If IWP student then course in which admission is sought ......................................................................
Age ........................................................... Date of Birth.......................................................................
Father ’s Name .....................................................................................................................................
Mother ’s Name.....................................................................................................................................
Father ’s Occupation & Address ...........................................................................................................
(if business give details) ........................................................................................................................
Status : Single
 
Married
 
  Widow
 
Address (Permanent) ...........................................................................................................................
.............................................................................................................................................................
Phone No. (with STD code ) .................................................... Mobile ..................................................
Local Guardian           (i) Name ...................................... Phone / Mobile ..............................................
                                       Address .........................................................................................................
                                   (ii) Name ....................................Phone / Mobile ...............................................
                                        Address .........................................................................................................
Contact in Emergency, Name ........................................ Phone / Mobile ...............................................
Vegetarian / Non Vegetarian ................................................................................................................
Any Special information you would like to mention ..............................................................................
.............................................................................................................................................................
I hereby certify that I shall abide by all the rules of the Hostel regarding going to market, movie, and local guardian ’ s place or seeing visitors.

                                                                                                               Signature of the Applicant
I certify that my ward will pay full Hostel dues in advance and will abide by the rules and regulations of the Hostel that may be enforced from time to time. I understand that Hostel fees once paid will not be refunded or adjusted.

Signature of the Candidate    ________________                                Date   ________________



STUDENT DECLARATION

I .............................................................. D/O / W/O ..........................................................................
Course ..................................................................... solemnly declare that the information given by me is true. I will follow all the rules of the Hostel. I will not let down the dignity of the Hostel, under any circumstances even if somebody misguides me.

Signature of the Student                                                                  Signature of the Parent / Husband

Date: .............................                                                                   Date: .......................................

PARENT / GUARDIAN’S DECLARATIO

I request you to give admission to my Daughter / Wife in your hostel. I promise you that my daughter / wife will follow all the rules and maintain discipline in the Hostel. If she is found to be indisciplined then you can dismiss her from your hostel and you can send her to her local guardian.

Parent / Guardian Signature : ..............................................................................................................
Name of the Student: ..........................................................................................................................
Name of the Father : ...........................................................................................................................
Name of the Mother : ..........................................................................................................................
Address (Permanent) : ........................................................................................................................
Phone : ...............................................................................................................................................
Mobile : ..............................................................................................................................................
Mail Id : .............................................................................................................................................

WARDEN’S CERTIFICATE

Admission should be given or not : .....................................................................................................
Director : ...........................................................................................................................................

Note: *Incomplete forms will not be accepted.
 *Hostel fees will not be refunded or adjusted.


   INTERNATIONAL WOMEN POLYTECHNIC
HOSTEL
 RULES AND REGULATIONS

  1. Availability on first come first basis.
  2. The Society has the right to reject any application of the Students/Candidates/Working Women.
  3. Students of the polytechnic get the first right to accommodation at all times.
  4. Police verification of candidates is a must and we expect the Students/Candidates/Working- Women to co-operate and comply.
  5. Discipline to be maintained at all times.
  6. Arguments amongst students/Hostel Warden/Care Taker will not be tolerated.
  7. Students/Candidates/Working Women who try to misbehave, with any of the Polytechnic ’s Staff/ Hostel Staff/ Hostel Inmates will be told   to leave the hostel within 24 hrs. and no amount/hostel fee/deposit will be refunded.
  8. There should be no altercation between the occupants. In case of any physical assault the offending occupant will immediately be asked to leave the hostel within 24 hrs. The Management/Society of the Hostel has the right to forfeit her security deposit and the advance Monthly Fee/Other Fee etc …
  9. Students/Candidates/Working Women are expected to take care of their belongings like mobiles, laptop, jewellery, purses, cash, credit-cards, debit-cards, clothes etc at all times. The Hostel will not take any responsibility for their belongings.
  10. Since it is a women ’ s hostel, only parents of female candidates or female accomplices are allowed inside the hostel. No male visitors are allowed inside the Hostel. Any request otherwise, by any hostelier will never ever be entertained.
  11. Light, fans, coolers, AC ’ s, computers should be switched off when nobody is in the room.
  12. No electrical appliances eg. Room heater, kitchen heater, blower will be used by the students without written prior permission of the concerned authority. If at all they are to be used, it will be on extra payment
  13. T.V: - No Students will watch T.V after 10 pm especially NO LATE NIGHT MOVIES.
  14. T.V should be watched in very low volume, so that other students are not disturbed.
  15. No one will lock their rooms when going out. The duplicate keys of the room-lock should always be with the Hostel Warden/Hostel Care Taker.
  16. No inmate will be allowed to go out of the hostel after 9 p.m without the permission of hostel warden. Such inmate will sign late night register indicating reasons for leaving the hostel late night.
  17.   Inmates are expected to be in the hostel premises by 9 p.m every day. Hostel gate will be closed at 9 p.m everyday.
  18. Inmates proposing to spend a night out or day out have to inform the warden in advance / beforehand giving the address, telephone no., where they could be contacted in case of emergency.
  19. Any inmate who returns to the hostel after the gate has been closed will be treated as default and will be viewed with seriousness.
  20. Any case of illness shall be reported immediately to the hostel authorities. If necessary the residents will be shifted to the hospital. All expenses incurred to the hospital, all expenses incurred on any medical assistance (including transport charges if any.) provided to the resident will be borne by the resident herself.
  21. Pets are not allowed inside the hostel premises.
  22. The inmates shall be responsible for the proper up-keep of the furniture and fittings etc. Any damage to these including the glass panes or electric fittings is to be made by the inmates concerned. No inmate shall remove any furniture or other fittings from the allotted places.
  23. Inmates have to give one month written notice, to be counted from the date such notice is received in the hostel office or pay full charges for the period in lieu of the notice, if intending to leave the hostel for good. All charges should be paid in full as per the prescribed schedule before termination of stay.
  24. Hostel charges as fixed by the management will be payable by each inmate and these are subject to revision unilaterally as and when considered necessary without any prior notice. The schedule of rates in force at the time of allotment is available at the hostel office.
  25. The hostel fee has to be paid on the due date. Fine for the late submission of fee is Rs. 200/- per day.
  26. Rooms will be liable to inspection by the hostel authorities as and when necessary.
  27. Hostel inmates shall take prior return permission from the hostel authorities (Warden/Care Taker) before giving any information or interview regarding hostel to any member of the Press, Radio, Television or any other media before making any speech containing any information regarding the hostel.
  28. The Management decision will be final and binding at all times.


    Signature of the Candidate ________________                             Date   _______________

 

UNDERTAKING

This is to affirm that I Have read and understood the Rules and Regulations of the hostel and I shall abide by then. I also understand that all amount including Hostel fees shall not be refunded to me by the Hostel authorities under any circumstances.

Signature of the Candidate ________________                             Date   _______________

 

 

 

To                                                                                                                                                                                                                                                               Dated:
The Management/Manager,
International Women Polytechnic,
The Hostel,
New Delhi.

Sir/Madam,
                     
                      This is to request you to please allow me to stay in your esteemed Hostel. I, hereby state that I D/O __________________________________ R/O _______________________________________ Guardian’s Address ______________________________________________________________, if any, am above 18 years of age (DOB proof attached, herewith), stating that I am a major.

I, also, undertake and understand that, I am fully responsible for any action taken by me at any given point of time during my stay in the Hostel premises, or otherwise.

 

Thanks.

Signature _______________________

Name _______________________