Lukhdhirji Engineering College, Morbi

Form for Renewal of Hostel Admission

To,
The Rector,
L. E. College,
Morbi. PHOTO
Sub. : An application for renewal of hostel admission.
Respected Sir,
I have been staying in hostel and I want to get my admission renewed for the current term.
Name of student : _______________________________________________________
Student’s mobile no.: _______________________________________________________
Father’s name (Full) : _______________________________________________________
Father’s address : _______________________________________________________
: City ______________ PIN __________ Mo. No. ________________
Category : OPEN / SC / ST / SEBC / PH / Ex. Ser. _____________ Cast ______________
Details of stay in the hostel :
(a) Date of 1st admission in the hostel : Date : _______________________
Room No. : ________________ Hostel : ____________
(b) Details of last stay in the hostel : Room No. : ________________ Hostel : ____________
Term : ____________________ Receipt No. : ________
Branch : __________________ Date : _____________
Enroll.No.:_________________ Amount paid Rs._____
(c) Details of current semester : College fee Receipt No._______Date : _____________
Enroll.No.:_________________Sem. : _____________
(d) Room applied for hostel : Room No. : ________________ Hostel : ____________
(e) Previous details : From 1st sem. whether punished by authority.
_________________________________________________________________________
I hereby solemnly declare that the above information is correct and if the information is found
incorrect my admission is liable to be cancelled and disciplinary action may be taken against me.
I shall abide by hostel rules and regulations formed by hostel authority from time to time.
Place : _______________
Date : _______________ (Signature of student)
Instruction : Students have to bring with them their Hostel and College Identity Card with
College Fee Receipt of current semester.
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The information supplied is verified by me and found correct
He may be allotted room in hostel
Signature of Warden

Admission is Granted / Not Granted Rector

Receipt No. __________ Date : ____________ Cashier’s Signature