Hostel Admission Form

To,
The Hostel Administration,
Kumaraguru Hostels,
Coimbatore - 641049.

DATE : 09/07/2024 16:43

I wish to apply for admission to the hostel for the academic year 2024 – 2025. I am giving below
the necessary information.

Roll No.: 22BCS059 Name of the Student MANI BHARATHI B

Course Name B.E - COMPUTER SCIENCE Date of Birth 29/08/2003
AND ENGINEERING
Gender Male Blood Group O +Ve
Mobile No. 8807687498 Email-ID [email protected]
Allergic to any Medicine or Medical Condition that needs attention, if Yes, Please mention:
NA
Address for Correspondence Permanent Address
No:19 Vakeesam nagar, Near uma gas Vadalur No:19 Vakeesam nagar, Near uma gas Vadalur
Kurinjipaadi, Vadalur Tamil Nadu India - 607303 Kurinjipaadi, Vadalur Tamil Nadu India - 607303
Father Name BABU K Father Occupation State Government
Father Mobile No. 9994269462 Father Email-ID [email protected]
Mother Name CHITHRA B Mother Occupation Home Maker
Mother Mobile No. 9952487926 Mother Email-ID
Guardian Name BABU K Guardian Occupation State Government
Guardian Mobile No. 9994269462 Landline No.
Guardian Address No: 19, vakeesam nagar, near uma gas , vadalur 607303
Name of the Relative / Visitor (Other than Parents / Local Guardian) with address and Phone No.
Visitor Name Visitor Mobile No.
Visitor Address
Whether the student will travel alone or with the Parents / Local Allow to travel alone
Guardian at the time of Holiday of the Institution.
In case of emergency, whom should be contacted?
Contact Name BABU K Mobile No. 9994269462

Page No.: 1
Landline No. / Relationship with Father
Office No. Student

Declaration by the Student

· I have carefully read and understood all the rules and regulations apart from the above-mentioned main
extract of those rules and regulations. The full set of rules and regulations are available on the college
websites (www.kct.ac.in , www.kclas.ac.in, www.kctbs.ac.in). I will follow the rules and regulations and
subsequent amendments if any as laid down by the Management.

· I understand that suitable action can be taken against me if I do not abide by the rules & regulations of
the Institution. If I leave the Hostel on my own or I am expelled from the Hostel in the midst of the
academic session, I will not be entitled to claim any refund.

· I certify that the information above is true to the best of my knowledge and belief. I further declare that if
anything happens to me or any kind of mishaps occurs outside / inside of the hostel due to my negligence
/ fault, the management will not be responsible for that.

Signature of the Student Signature of the Parent

( MANI BHARATHI B ) ( BABU K )

For office use only

Date of Admission in Hostel
Allotted Block Name Allotted Room No.

Signature of the Caretaker Hostel Administration

Page No.: 2
 Undertaking Form
Date : 09/07/2024
Name of the Student : MANI BHARATHI B Roll No.: 22BCS059
Department : B.E - COMPUTER SCIENCE AND ENGINEERING Mobile No. : 8807687498

The Kumaraguru hostel resident are expected to adhere all the rules and regulations Laid down to maintain
to learn peacefully.

Hostel Entry / Exit requirements

· Identity cards issued by the college is to be mandatorily worn to gain entry/exit into/from the
hostel premises.

· Identity cards shall be produced on request to any authorities/officials during the entry/exit from the
hostels.

· The loss/damage of Identity card should be promptly reported to the authorities through email
([email protected]) for replacement.

Permission to leave Hostel

· Hostel residents shall request permission for outing. The holiday outing is between 07.00 am and
08.30 pm. For girl residents, the holiday outing timing on Sundays is from 7.00 am to 7.00 pm.

· Late entry into the hostels will be monitored. Frequent latecomers will be referred to the Disciplinary
Committee and their recommendation will be implemented which may include denial of hostel
admission during the subsequent academic years, expulsion from hostels.

· The student residents leaving for an outing shall make required entries in the appropriate register before
leaving / entering the hostel campus.

Screening of Baggage
· Baggage including food packs being taken into/out of the campus/hostels will be subject to check.
Kindly extend cooperation for the baggage checks at all the gates.

Online Food Order / Delivery guidelines

· Online Food order deliveries will be permitted till 09.00 pm at the college gates. The hostel residents
shall ensure that the food orders are made well in advance so that the food reaches the campus
before 09.00 pm.

Page No.: 3
 Disciplinary Process

· Disciplinary proceedings will be initiated against those student residents who possess/consume
alcohol, cigarette, or narcotic substances and those who are found involved in such activities will
warrant immediate expulsion from the hostel (zero tolerance policy will be followed).

· Student residents engaged in fighting, bullying, betting, theft, or any other activities that are against the
rules and regulations of the Kumaraguru hostels will be suspended from the hostels based on an enquiry
and the recommendations of the Disciplinary Committee will be implemented.

· Those students who do not conform to any of the rules and regulations of the hostels will not be
considered for admission into the hostels for the subsequent academic years, besides disciplinary action
as deemed appropriate.

Declaration by the Student

· I have carefully read and understood all the rules and regulations apart from the above-mentioned main
extract of those rules and regulations. I will follow the rules and regulations made available in the college
websites (www.kct.ac.in, www.kclas.ac.in, www.kctbs.ac.in) and subsequent changes / addition if any as
laid down by the college administration.

· I understand that suitable action can be taken against me if I do not abide by the rules & regulations of
the Institution. If I leave the Hostel on my own or I am expelled from the Hostel during the session, I will
not be entitled to claim any refund.

· I certify that the information above is true to the best of my knowledge and belief. I further declare that
if anything happens to me or any kind of mishaps occurs outside / inside of the hostel due to my
negligence / fault, the college administration will not be responsible for the same.

Signature of the Student Signature of the Parent

( MANI BHARATHI B ) ( BABU K )

Page No.: 4