Hostel Admission Form

Application Date:
Enrollment Id:
*For Existing Students
Name :
Surname :
Gender :
Marital Status :

Student Image Upload



Course Details


Graduation :
Course :
Course Year :
Academic Year :
Course Semister :
Batch :
Admission Category :

Personal Details


Nationality :
Religion :
Blood Group :
Mother Tongue :
Cell No. :
E-Mail:
Date Of Birth :
Place Of Birth :
Mole-1 :
Mole-2 :
Aadhaar No. :
PHC :
State :
District :
Mandal :
Village :
Room Type:
(Subject to Availability)

Family Details


Father Name :
Mother Name :
Father Cell No. :
Mother Cell No. :
Father Occupation :
Father Mail :
 
Guardian Name:
Guardian Cell No :

Address Details

Present Address

H.No :
Street & Village :
District :
Pincode :



Permanent Address

H.No :
Street & Village :
District :
Pincode :


Hostel Information
Have ever been removed from the Hostel Earlier :



Hostel Application Fee: Rs.100/-
Mode Of Payment :


Bank Account Details

A/C NAME : DR YSR NITHM, HYDERABAD
A/C NO : 187901000002800
IFSC CODE : IOBA0001879
BANK : INDIAN OVERSEAS BANK
BRANCH : GACHIBOWLI

Receipt Number:
Receipt Date:
Receipt Image Upload Receipt


Terms & Conditions