National Institute of Food Technology Entrepreneurship and Management (NIFTEM)
National Institute of Food Technology Entrepreneurship and Management (NIFTEM)
HOSTEL APPLICATION FORM
Registration No: - …………………………………….
1).Name: - …......
2).Date of Birth: - ………………………………… 3).Sex:- ……………………………………………….
4).Fathers Name: - ……………………………………………………………………………………………….
5).Mothers Name: - ……………………………………………………………………………………………….
6).Address for Communication:-………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………….
Ph. No. ……………………………………………. Mob. No. …………………………………………………………………… Email………………………………………………………………………….
7). Blood Group :-……………………………………………………….
8).Program in Which Admitted: - ……………………………………………………………………………………………
9). Batch:-……………………………………………………………………………………………………………………………….
10).Details of Parents and Local Guardian:
11).Emergency contact Details: -Mob. No…………………………………..; Landline No. (STD Code)……………………………………………………………………
Undertaking from the Student and Guardian
Undertaking from the Student and Guardian
I, Mr. /Ms...... ,
Program: ...... Batch...... , student of
NIFTEM (Kundli) do hereby undertake on this day …………… month………………………….
Year …………………………, the following:
1. I will maintain strict discipline and decorum in hostel.
2. I will abide by code of conduct of hostel and Institute and will respect other residents of hostel.
4. I will not create any situation whereby hostel residents are disturbed.
5. I will strictly maintain the mess and hostel timings.
6. I shall abide by the admissible rules and regulations of NIFTEM and follow the code of
Conduct for students I acknowledge that the Institute has the authority of taking disciplinary action on me for non-compliance of the same.
7. That I understand the meaning of Ragging and know that the ragging in any form is a
Punishable offence and the same is banned by the Court of Law. I understand that, in case I
am involved in ragging, the case will be reported to the police and the law will take its own
Course and I will be summarily expelled from the institute.
8. That I have not been found or charged for my involvement in any kind of ragging in the past.
However, I undertake to face disciplinary action/legal proceedings including expulsion from
The Institute if the above statement is found to be untrue or the facts are concealed, at any
Stage in future.
9. That I shall not resort to ragging in any form at any place and shall abide by the rules/laws
Prescribed by the Courts, Government of India and the Institute authorities for the purpose
From time to time.
10. In the event of my involvement in any activity outside the campus which is punishable by the law of the land, the institute shall in no way provide any support to me and will be not be
Responsible either for my action.
Signature of Student
Date:
I hereby fully endorse the undertaking made by my child / ward. I also give my consent to Gate Pass System, prevalent from time to time
Signature of Mother /Father and or Guardian
Name:-……………………………………………………………
Date:-……………………………………………………………. (Signature of the Respective Warden)