COMSATS Institute of Information Technology

COMSATS Road off G. T. Road, Sahiwal
Tel # 040-4305001-3, Fax No. 040-4305006

Girls Hostel Record Form
                                                          DOC#CIIT-SWL/HT/FORM-02 Rev 00

Affix two Passport
Form No.:___________ (for off. Use)	Girls Hostel:  _______________  (for off. Use)	Size Photographs

Here

Have you ever availed CIIT Hostel facility?	Yes		No				

Are you availing any scholarship at CIIT Sahiwal?										
		Yes			No				
If yes, mention Title of Scholarship:	_____________________________________________________________		

Section A:

Student’s Personal Information:
(To be filled by the applicant and must be complete in all aspects)

Student’s Name:
(In Capital Letters)

Father’s Name:
(In capital Letters)

Guardian’s Name (if any):
(In Capital Letters)

CNIC Number:

					-								-		
Programme of the Study:

Registration Number:

Permanent Address:

Correspondence Address:

Personal Number: _________________	Email: ______________________

Person’s name and phone number to be contacted in case of emergency:

Name:	Relationship:	Phone Number:	

Undertaking by the Applicant

I, ___________________________ S/o/D/o______________________________ do hereby solemnly affirm and undertake that:
1.	The information given by me above is true and complete to the best of my knowledge and nothing has been concealed / suppressed. 

2.	I shall abide by all the rules, orders, instructions, information, guidelines, code, and circulars etc. in forced by the institution. 

3.	The Management will be at liberty to impose any penalty or any disciplinary action(s) on me being found guilty of, any sort of misconduct or indiscipline or disobedience or malpractice within or outside the hostel, or any act which is detrimental to the interest of the institution. 

Date:_______________________	Signature of the applicant:_______________________

Section B:
For official Use only

Student File No.:- ____________________________________________________________________

Girls Hostel No.:-_______________________________________________________________

Room No.:-________________________________________________________________________

Seat No.: -_______________________________________________________________________

Hostel Fee:_________________________________________________________________________

Scholarship (if any e.g. ICT):___________________________________________________________

Comments (if any):

__________________________________________________________________________________

__________________________________________________________________________________

Assistant Warden Name:-__________________________________________________________________________

Girls Hostel:-________________________________________________________________________________
(Complete Address)

__________________________________________________________________________________

Date: __________________	Assistant Warden’s Signature:-_________________

Section C:
Details of visitor authorized to visit the female student in hostel:
(This section must be filled by the father/guardian of the female student staying in COMSATS’ hostel)

I,_________________________ being the father/guardian of ___________________ authorize Mr./Ms. _________________________________ to visit my daughter/sister/……. in the hostel in accordance with procedure specified by the hostel Management.

Father’s/Guardian CNIC:

					-								-		
Visitor’s CNIC:										
					-								-		

Visitor’s Relationship with the student: __________________________________

Affix a Passport Size Photograph of a Person Authorize to Visit the Female Student

Date: ______________	Signature of the Father/Guardian:________________

Note:  CNIC copies of the student, father/guardian and visitor must be attached with this form.

*Hostel security will be refundable within one year of leavening hostel.