To, The Hostel Warden

Sir,

HOSTEL ADMISSION FORM

2020-2021

I wish to apply for admission to the hostel from ……..…………… to ……………… I am

giving below the necessary information. 1. Name of the applicant (in Block Letter) :

2. Programme/Branch/Class/Semester :

3. Father’s Name :

4. Mother’s Name :

5. Date of Birth : 5. Blood Group :

6. Allergy to any Medicine if Yes, Please mention :

7. Email ID : 8. Mobile No. :

9. Address of Correspondence (in Block Letter) :

Phone No. :

10. Permanent Address :

Phone No. :

11. Name and Address of Local Guardian :

Phone No. :

12. Occupation/Designation of :

Father : Mother :

Local Guardian :

NH-12, Chaksu Bypass, Tonk Road, Jaipur-303901

Photo

Contd... 2

-2-

13. Name of the relatives/visitor (Other then Parents/Local Guardian) with address

and Phone No.

i)

ii)

iii)

14. Whether he/she will travel alone or with the Parents/Local Guardian at the time

of Holiday/of the Institute.

15. In case of emergency, we can contact Mr./Ms./Mrs

at Residence Phone Office No.

Relationship with you .

Declaration by the applicant

1. I have carefully read and understood all the rules and regulations mentioned

above. I will follow the rules and regulations and subsequent changes/addition if any as laid down by the Management.

2. I understand that a suitable action can be taken against me if I do not abide by the

rules & regulations of the Institute. If I leave the Hostel on my own or I am

expelled from the Hostel in the midst of the session, I will not be entitled to claim

any refund.

3. I certify that the information above is true to the best of my knowledge and belief. I further declare that anything happens to me or any kind of mishaps occurs

outside/inside of the hostel due to my negligence/fault, the hostel authority will not be responsible for that.

4. I understand that in case of any natural calamities, management will not be

responsible for any losses and damages.

Signature of the Student

Signature of the Father/Mother Signature of the Local Guardian

For Official Use Only

Date of Admission in Hostel : Room Allotted :

Signature of the Hostel Superintendent Signature of the Hostel Warden

JAGANNATH UNIVERSITY

HOSTEL RULES AND REGULATIONS

1) INTRODUCTION:

The aim of our Hostel is to make it a Home away from Home. The air cooled Hostel have the

ambience with the Main focus on studies and to bring out latent qualities of the students by promoting

sports, cultural activities and Interpersonal development.

a) To provide congenial atmosphere and to maintain discipline the allotment of the hostel

accommodation is provisional subject to the satisfactory academic performance and discipline of the

student.

b) The 1st

appraisal of the student about the academic performance & discipline will be made after one

month of his admission to the Hostel. If the student is not upto the expectation he will be given a

warning.

c) 2nd

appraisal will be made after two months and if the student does not improve in spite of the

warning, he will be expelled from the Hostel.

d) The Student whether leaving the hostel on his own or expelled from the Hostel in the midst of

the session will not be entitled for any refund/ claim for the Hostel Money.

e) The allotment of the hostel accommodation is valid only for one academic session, ending on the

last day of your regular examinations.

f) A fresh application is to be made for the new academic session. The allotment of the hostel

accommodation in one session does not guarantee accommodation in the successive academic

session.

2) GENERAL:

a) All residents of the hostel are required to follow the hostel rules and regulations.

b) Allotment of rooms is solely at the discretion of the administration.

c) Hostel facilities include boarding and lodging. It is meant for those students who are not residents of

Jaipur, are serious in their studies, can maintain proper discipline and decorum and make regular

payments against hostel charges.

d) The rooms are provided with cots, mattresses, tables, chairs, almirah, & wardrobe.

e) Residents are not allowed to bring their personal furniture to their rooms unless they have obtained

prior written permission from the Warden for doing so.

f) Loitering around the campus after 09:00 PM is strictly prohibited.

g) Hostel residents will be solely responsible for any offence or casualty caused to individuals inside or

outside the campus.

h) The rooms shall be open to inspection by the Hostel Warden / Management, any time.

i) The use electric appliances except computer/laptops are banned in the hostel.

j) Students must obtain a “No Dues Certificate” from the Warden before leaving the hostel at the end of

the session.

k) Students are required to be in the University premises before 8 p.m for Boys and 6 p.m for Girls

and in the hostel premises after 09 pm for Boys and 6 pm for Girls.

l) Students are not permitted to keep any type of music system (Extra speakers/woofers) in their

rooms.

m) Parties of all nature are banned in the hostel premises (Specifically ‘Birth Day Party’ at night)

n) During the class timings students are expected to attend all the classes regularly & punctually.

o) If any day-scholar is found to be present in the hostel in the collusion with the hosteller, the

former will be suspended from the university and the latter will be suspended from both the

hostel and the university.

p) Without prior information of the hostel warden, not even a single hosteller will enter another

hostel.

3) APPLICATION FOR ADMISSION:

Application for admission is to be submitted to the Hostel Warden on the prescribed Form available

in the Hostel Office and must be accompanied by self addressed stamped envelope & three passport

size photographs. No students shall become local guardian of any other student.

4) HOSTEL CHARGES:

a) The Hostel fees for the whole session from the commencement of the academic session to the last

day of the examination of the academic session or last day of the practical training as per

curriculum whichever is latter is * [ Rs. 1,05,000 per academic session & 5000 f o r t w o

s e a t e r N o n - A / C , R s . 1 , 1 5 , 0 0 0 p e r a c a d e m i c s e s s i o n & 5 0 0 0 f o r t w o

s e a t e r A / C a n d Rs. 81 ,000 per academic session & 5000 f o r t h r e e s e a t e r N o n -

A / C a n d R s . 9 5 , 0 0 0 per academic session & 5000 f o r t h r e e s e a t e r A / C a n d

R s . 7 1 , 0 0 0 p e r academic session & 5000 f o r f o u r s e a t e r] as caution money

(refundable) is required to be paid at the time of provisional admission to the Hostel accommodation.

b) Hostel and Mess charges can be revised any time without prior information, and students have

to comply with accordingly. In this regard the decision of Management shall be final and

binding.

c) Once the student takes admission in hostel, he/she can't leave the hostel before completion of the

programme. Otherwise a penalty of Rs. 25,000 shall be charged from him/her.

5) MESS RULES:

a. Only vegetarian meals would be served.

b. Residents should take all their meals in the Dining Hall of the Mess only. The meals include

morning tea, breakfast, lunch evening tea and dinner.

c. Residents will be served meals only during the prescribed timings, which will be displayed on the

Notice Board from time to time.

d. There will be a common menu for all the residents.

e. Residents should not carry their meals wholly or in part outside the Mess to their room, nor

should they carry any utensils or other property of the Mess outside the Dining Hall.

f. Residents should be properly dressed for the Mess. They may not come in

dressing Suits / night wear etc.

g. Residents should not interfere with cooking or other services and shall not meddle

with the Mess equipment.

h. Sick residents may be allowed to eat their meals in their rooms with the written

permission of the Warden. They may obtain special sick-diet, such as porridge,

cornflakes, toasts and milk etc, on the recommendation of the Medical Officer or

with the permission of the Warden and on prior intimation to the Mess contractor.

i. No guest shall take breakfast, lunch, tea or dinner without prior permission of the Hostel

Warden. If permitted, the host resident shall pay the charges in advance to the

contractor.

j. Residents should cooperate with the Mess employees and deal with them in a polite and courteous

manner.

k. If residents want to miss any meal i.e. breakfast, lunch / dinner they are advised to inform the canteen

contractor in writing in advance.

*Revised fee structure (Hostel) for Academic Session 2020-21 only

Room Type 2 Seater 3 Seater 4 Seater

AC 81,000/- 67,000/- -

Non-AC 74,000/- 57,000/- 50,000/-

6)ENTRY IN / OUT OF THE HOSTEL:

a. Residents shall not go outside their rooms after Roll Call at night till 6:00 AM next morning without

the written permission of the Warden, except for attending Institute functions or authorized academic

work in the Institute. Attendance may be taken during these hours.

b. Residents shall not leave the station without obtaining the prior permission of the Warden.

c. Residents shall not invite any unauthorized person into their rooms. They shall deal with only

authorized vendors, washer-men, cobblers etc. during the prescribed hours and pay them directly.

d. No resident shall stay in the hostel during the Institute hours without a valid reason, permission

for which must be taken from the Warden.

e. No resident shall leave the Institute Campus during University working hours without permission.

The Out-Pass shall be issued for valid reasons by the Hostel Warden / Course Co- coordinator /

Proctor.

f. For leave of absence form the Hostel during night or for longer period an application is to be

submitted to the Proctor / Course Coordinator through the Warden, well in advance. Only after

getting the leave sanctioned, the resident should proceed on leave. Proceeding on leave without

permission or overstay of sanctioned leave will constitute an act of indiscipline.

g. No resident shall leave the Institute Campus without making necessary entries in the register kept

with the guard at the hostel and at the main gate.

7) USE OF FACILITIES:

a. A student who has opted for the Hostel accommodation shall reside in the allotted hostel room only.

b. Residents shall be responsible for all furniture, electrical and other fixtures in their rooms. They

should not disfigure or paint on the walls, doors and windows or otherwise damage them.

c. Once allotted, the change of occupancy of the room without permission of the Warden is not allowed.

d. Residents shall not use heaters or any other power appliances in their rooms.

e. Residents should maintain decorum and dignity and should not create any nuisance or disturbance,

which may disturb / annoy the neighours.

f. Room lights / cooler must be switched off when the resident leaves the room. The defaulter shall be

fined Rs. 50/- each time.

g. Residents should inform the Warden in writing on the prescribed form & enter in the Register kept

with the Hostel Guard when they suffer from illness or injury. Charges for stay at hospital,

consultations, medicines, taxi/vehicle etc. will be borne by the residents.

h. Residents should not visit or stay in any other room than the one allotted to them after Roll Call

without prior permission of the Warden.

i. Residents should not organize any party, assembly or activity without the permission of the Warden.

j. Residents shall not remove any furniture, games, materials from the recreation rooms or mishandle or

damage them.

k. Residents shall obey the directions of the Wardens and follow their instructions on all matters

concerning the Hostel / Mess.

l. During academic working hours of the university power-backup will not be provided in the

hostel

m. During power failure of electricity board air cooling machine will not run.

8) GUEST / VISITORS:

a. They are to be received in the reception lounge only. Residents are not allowed to take visitors to

their rooms. If under special circumstances, a resident want to guest / visitor to his room, he must take

special permission from the Warden.

b. No visitor or parents are allowed to enter the hostel rooms without prior permission of the Warden.

9) Hostel Committee will be formed by the Administration comprising Hostel Student’s representative

and Wardens to ensure smooth functioning of the Hostel and its activities regarding Hostel.

10) Action would be taken against a Hosteller, which may lead to the cancellation of his /her

allotment of the Hostel accommodation, if:

a. His / her stay in the Hostel is found to be not congenial to the Hostel atmosphere.

b. A criminal charge is registered or an FIR has been lodged / an enquiry is in progress against him / her.

c. He / she has been a habitual defaulter in making payment of dues.

d. He / she has been irregular in attending the class lectures and / or has failed to show good

performance in studies or has failed to appear at the examination / tests.

e. He / she has failed to vacate his her room immediately after his / her examination as required

under the rules or has not obtained the “No Dues Certificate” from the Warden on leaving the

hostel after vacating the room.

f. He / she is found guilty of misbehavior with the hostel employee(s) Warden / Asstt. Warden or

fellow hostellers, and has failed to improve his / her conduct in spite of verbal / written warning by

the hostel administration.

g. He / she is found stealing hostel property like electric bulbs, tube-lights, curtains, utensils, etc.

h. He / she tries to cause any damage to the Hostel property.

i. He / she is found to have in possession of any article belonging to the Hostel / Institute which he /

she has taken away without prior permission of the concerned authorities.

j. He / she is found sharing his / her room with any outsider or day scholar without the written

prior permission of the Warden.

k. He / she is found involved in other illegal activities including gambling, gherao and making noise

at night etc.

l. Cancellation of admission in the college would mean cancellation of hostel accommodation also.

m. Smoking is strictly prohibited in the campus.

n. The use of intoxicants-alcohal, zarda, gutkha etc are strictly prohibited in the hostel as well

as university premises or in living room. No students will come to the hostel in an inebriated

condition.

o. Any student can be asked to get medical check-up on suspicious on intoxicants consumption.

p. Residents found guilty under clauses (b), (j), (k), (m) & (n) may be summarily expelled from

the Hostel by the Warden.

11) IF HE/SHE IS FOUND INVOLVED IN RAGGING, HE/SHE WILL BE EXPELLED

FROM THE HOSTEL UNIVERSITY IMMIDIATELY.

12) DAMAGE / BREAKING CHARGES:

a) Hostellers will be responsible for their rooms and the furniture provided to them. Any breakage

or damage or theft of furniture etc. must be reported to the Warden / Asstt. Warden

immediately in writing who will take suitable action. If the student is found guilty of the damage to

the room and its furnishings, cost of the repair along with a fine would be recovered from him.

b) The students would also be responsible jointly for common faculties provided to them in the

Hostel and in the Mess. Any breakage / damage or theft of the common facilities must be

reported by the student / students to the Warden / Asstt. Warden immediately in writing. The

cost of the repair / replacement along with a suitable fine imposed would be required to be shared

by all the students if they fail to establish an individual / group of the student / students for the

offence.

13) The Hostel shall remain closed during vacations as & when declared by the Administration.

The students are required to vacate the Hostel and remove their belonging form the room during

summer vacations. Moreover, the inmates may be asked to vacate the rooms at any time by the

administration.

14) The allotment of the hostel accommodation is only for one academic session. After the

completion of the academic session, the student will vacate the hostel (within three days).

15)

a. On matters not covered by these rules, the discretion of the Administration shall be final

and binding.

b. The Institute Management has full right to deny accommodation to any or all the students

at any time in the overall interest of the Institute.

c. The Institute Administration reserves the right to change the rules and regulations in

the overall interest of the Institute.

16) MISCONDUCT

The following cases would amount to breach of discipline and shall constitute as misconduct:

Absence from the hostel without prior permission

Absence from hostel beyond permissible time

Destroying/Damaging the property of the hostel

Misbehavior with other students and staff of the mess/hostel

Disfiguring walls and furniture etc. of hostel

Any breach of hostel rules

Physical Violence

Possession/use of drugs, alcoholic beverages & obscene literature and indulging in obscene

act/gesture

Noise through music system in the hostel

Any other act against the interest of students in general and prejudicial to the reputation of the

University

17) FIR MAY BE LODGED

a. Keeping of weapons in personal possession or in the room is criminal offence, which may lead to

immediate expulsion from the hostel.

b. Keeping in possession a stolen article is a serious offence, which may lead to immediate expulsion

from the hostel.

c. FIR will be lodged for any criminal offence committed in the Hostel/ campus.

DECLARTION BY THE APPLICANT:

1. I have carefully read and understood all the rules and regulations mentioned above. I will

follow the rules and regulations and subsequent changes / addition, if any, as laid down by

the University.

2. I understand that a suitable action can be taken against me if I do not abide by the rules &

regulations of the Institute. If I leave the Hostel on my own or I am expelled from the

Hostel in the midst of the session, I will not be entitled to claim any refund.

3. I hereby undertake that if I stay outside the campus, I shall be doing it at my own risk and

responsibility and the University will not be responsible in any manner whatsoever.

4. I hereby understand that if I am found involved in ragging in any manner, I will be

expelled from hostel and university immediately.

(Name & Signature of the applicant) (Name and Signature of the Parent)

(In presence of the Hostel Warden)

Dated: Signature of the Hostel Warden

ANNEXURE I

AFFIDAVIT BY THE STUDENT

I,………………………………………….... (full name of student with admission/

registration/ enrolment number)s/o

d/oMr./Mrs./Ms…………………………………………,having been admitted

to…………………(name of the institution)……………………….., have received a

copy of the UGC Regulations on Curbing the Menace of Ragging in Higher

Educational Institutions, 2009, (hereinafter called the "Regulations") carefully read

and fully understood the provisions contained in the said Regulations.

1) I have, in particular, perused clause 3 of the Regulations and am aware as to what

constitutes ragging?

2) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am

fully aware of the penal and administrative action that is liable to be taken against

me in case I am found guilty of or abetting ragging, actively or passively, or being

part of a conspiracy to promote ragging.

3) I hereby solemnly aver and undertake that

a) I will not indulge in any behavior or act that may be constituted as ragging under

clause 3 of the Regulations.

b) I will not participate in or abet or propagate through any act of

commission or omission that may be constituted as ragging under clause 3 of the

Regulations.

4) I hereby affirm that, if found guilty of ragging, I am liable for punishment

according to clause 9. 1 of the Regulations, without prejudice to any other criminal

action that may be taken against me under any penal law or any law for the time

being in force.

5) I hereby declare that I have not been expelled or debarred from admission in any

institution in the country on account of being found guilty of, abetting or being pat

of a conspiracy to promote, ragging; and further affirm that, in case the declaration

is found to be untrue, I am aware that my admission is liable to be cancelled.

Declared this……………….. day of……………. month of………. year.

VERIFICATION

Signature of deponent Name:

Verified that the contents of this affidavit are true to the best of my knowledge and no part

of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (place)

(day) of(month)(year)

on this the

Signature of deponent

Solemnly affirmed and signed in my presence on this the (day) of (month)

(year) after reading the contents of this affidavit.

ANNEXURE II

AFFIDAVIT BY PARENT/GUARDIAN

I, Mr./Mrs./Ms. (full name of

parent/guardian) father/mother/guardian of

,(full name of student with admission/registration/enrolment number) ,

having been admitted (name of the institution) , have received a copy

of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational

Institutions, 2009, (Hereinafter called the "Regulations")/ Carefully read and fully

understood the provisions contained in the said Regulations.

2) I have, in particular, perused clause 3 of the Regulations and am aware as to what

constitutes ragging?

3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am

fully aware of the penal and administrative action that is liable to be taken against

my ward in case he/she is found guilty of or abetting ragging, actively or passively,

or being part of a conspiracy to promote ragging.

4) I hereby solemnly aver and undertake that

a) My ward will not indulge in any behavior or act that may be constituted

as ragging under clause 3 of the Regulations.

b) My ward will not participate in or abet or propagate through any act

of

commission or omission that may be constituted as ragging under clause 3 of the

Regulations.

5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment

according to clause 9.1 of the Regulations, without prejudice to any other criminal

action that may be taken against my ward under any penal law or any law for the

time being in force.

6) I hereby declare that my ward has not been expelled or debarred from admission in

any institution in the country on account of being found guilty of, abetting or being

pat of a conspiracy promote, ragging; and further affirm that, in case the

declaration is found to be untrue, the admission of my ward is liable to be

cancelled.

Declared this-----------day of--------- month of-------------------- year.

Address: Signature of

deponent Name:

Telephone/ Mobile No.: VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no pat

of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (place) on this the (day) of (month) . (year) .

Signature of deponent

Solemnly affirmed and signed in my presence on this the

(day)…………….of(month)……………….. (year)……......after reading the contents of

this affidavit.

UNDERTAKING FOR HOSTLER

(Batch: 2020 -2021)

I hereby undertake that if I am found involved in violating any of the following conditions, the

university shall be free to take disciplinary action against me :

1. I am found inside the Hostel premises after 9:30 AM i.e. after commencement of the classes;

on any working day without seeking permission from the competent authorities.

2. I am found smoking, consuming alcohol, Pan-Masala, Zarda, Non-Vegetarian things within

the hostel premises.

3. I am found involved in violence or any other indisciplinary act in the hostel premises or

outside.

4. I am found in an inabriated condition, in the hostel premises.

I assure and undertake that it :

5. If I am expelled from the hostel for any objectionable activities during then the current

academic session, I will not be entitled for any refund of hostel fees, nor will I claim for the

above.

6. I will not go outside the campus without permission of respective wardens, and will strictly

obey the process of leave application and gate pass for coming in and going out of the

campus.

7. I am found carrying meals (wholly or in part) from the mess to my room or any room, or am

found carrying utensils or other property of the mess outside outside the Dining Hall, I will be

liable to pay fine as may be fixed by the University from time to time.

8. Day Scholars are not allowed to enter in the hostel premises : If any Day Scholar is found in

the room of hostler, the hostler will be suspended forthwith.

9. I shall abide all other rules and regulations of the University.

Date: / /2020

NAME: Signature of Student

COURSE:

SEMESTER:

Signature of Proctor Signature of Course Coordinator

Signature of Hostel Superintendent Signature of Hostel Warden

MEDICAL CERTIFICATE

(To be signed by a registered medical practitioner holding

M.B.B.S. degree) (To be submitted at the time of hostel

admission)

This is to certify that I have carefully examined Mr./Ms.

S/D/o Mr./Ms. whose signature is given

below

based on the examination, I certify that he/she is in good mental and

physical health and does not suffer from any infectious and contagious

disease harmful to others or may interfere with his/her studies.

Marks of Identification :

Signature of the candidate:

Place :

Date :

Name and signature of the Medical Officer

With Seal & Registration No.