DELHI TECHNOLOGICAL UNIVERSITY HOSTEL REGISTRATION FORM
(Formerly Delhi College of Engineering) ACADEMIC YEAR 2016 - 2017
Established under Govt. of Delhi Act 6 of 2009 SHAHBAD, BAWANA ROAD, DELHI, PH - 27852204
Form No: 2016M2759
MTECH
PERSONAL DETAILS ACADEMIC DETAILS
Name JITENDRA YADAV Reg No. / Roll No. 16100680
Gender MALE Branch ME
Personal Mobile No.9873703013 Semester 1
E - mail id jitendra11july@gmail.com BANK DETAILS
Admission category PG-OBC Account Holder Name JITENDRA YADAV
School RAJKIYA PRATIBHA VIKAS Bank Account No 4613001500021542
VIDHYALAYA, SHAMNATH MARG Bank Name PUNJAB NATIONAL BANK
NEW DELHI Branch Code 0461300
Back Papers(For 0 Bank IFSC Code PUNB0461300
Senior Students)
Branch Address JSS ACADEMY OF TECHNICAL
GATE Score: 505 GATE Rank: 11157 EDUCATION SECTOR-62 NOIDA
Blood Group AB+
Chronic Problems nil
PARENT'S DETAILS
Father's Name MUNIB RAM YADAV Mother's Name MALTI DEVI
Father's Mobile No. 9899412901 Mother's Mobile No. 9899412901
Father's E - mail id munibramyadav@gmail.com Mother's E - mail id
Father's occupation N/A Mother's occupation HOME MAKER
Father's Designation N/A Mother's Designation
Father's Office Address N/A Mother's Office Address
Father's Office Phone 0 Mother's Office Phone
PRESENT RESIDENTIAL ADDRESS PERMANENT RESIDENTIAL ADDRESS
Address Line B-65/C SWAROOP PARK Address Line B-65/C SWAROOP PARK
SAHIBABAD SAHIBABAD
City GHAZIABAD City GHAZIABAD
State UTTAR PRADESH State UTTAR PRADESH
Country INDIA Country INDIA
Pin 201005 Pin 201005
Residential Phone 9899412901 Residential Phone 9899412901
LOCAL GUARDIAN DETAILS
Name MUNIB RAM YADAV Occupation N/A
Address B-65/C SWAROOP PARK Office Address N/A
SAHIBABAD,GHAZIABAD Office Phone (Landline) 0
Phone 9899412901
____________________________
Signature of Applicant
Terms & Conditions :
1. No hostel resident is allowed to keep any motorized vehicle in the University. However, bicycles are permitted for
local/internal transport within DTU campus. Disciplinary action including fine and expulsion will be imposed on the
defaulters. In this regard an affidavit shall be submitted duly signed by student and his/her parents on a non-judicial
stamp of Rs. 10/-.
2. Once the hostel allotment is made no further request for change of room or hostel will be considered, if any such
request is placed by candidate then the candidature of that student will be treated as withdrawn and his/her
allotment will stand cancelled.
3. The students who have been admitted in the University under Outside Delhi category, but residing in Delhi, NCR
will be considered as Delhi Category student for the purpose of hostel allotment.
4. After the allotment of the room the allottee will be held responsible for any damage in his/her room, and the allottee
shall bear the cost of damage as decided by the warden and Officer Incharge, Hostel.
5. The day scholar has to take prior permission from the Warden & have to submit the fees before staying with
someone in the hostel and such permission shall be approved by Officer Incharge, Hostel Office atleast two days
before the requested date of stay.
6. The accommodation in the hostels will be provided as per the academic calendar declared by the DTU
administration/Dean Academics. Every student shall have to vacate the hostel within a week of his/her last end
semester examination every year. Each year a new allotement applicaion is to be submitted.
7. If any student tries to influence the DTU hostel administration through any means his/her candidature will stand
cancelled and the decision of the hostel office in such matters will be final.
8. Day scholars are not allowed to stay with any hosteller without prior permission, if any day scholar is found staying
with the hosteller in his/her room without prior permission of warden & Officer Incharge, Hostels, the allotment of
such hosteller will be immediately cancelled without any notice and such candidates will not be considered for
future hostel allotment.
9. Hostel office reserves all the rights for allotment, cancellation & rejection of hostel allotment applications. In this
regard the authority of Hostel Office/administration is final.
____________________________ ____________________________
Signature of Parents Signature of Applicant
I certify :
1. That I shall vacate my room within a week of last examination in each year.
2. That I shall abide the rules and regulations of University Hostels and the University and shall conduct in a manner
worthy of being a student of DTU and shall never indulge in indiscipline/voilence.
3. That the information furnished by me is true to the best of my knowledge and belief. If any information found wrong
my admission may be cancelled.
____________________________ ____________________________
Signature of Parents Signature of Applicant
Declaration by Parents :
I ___________________________________ s/o or d/o ___________________________________ undertake that
my ward will maintain good conduct during his/her stay in the University Hostel. I certify that statements made by my
ward are correct. I undertake to pay/arrange payment of dues regularly and keep regular contact with warden of the
hostel. If my ward is found in any undesirable activities, his/her hostel seat may be cancelled without any prior notice.
____________________________ ____________________________
Signature of Father Signature of Mother
Following Documents will be required duly attested -
1. Latest proof of parent's residence. (Latest electricity/water bill/gas connection bill/land line telephone bill/Aadhar
card)
2. Photocopy of Admission receipt.(B.Tech, M.Tech, MBA)
3. Photocopy of AIEEE/GATE score card.
4. Photocopy of Bank's passbook and cancelled cheque.
5. Hostel certificate from Principal of the school where he/she studied, if he/she is an outsider but studied in Delhi.
6. Medical fitness certificate issued by govt. authorized doctor.
7. SC/ST/OBC certificate if applicable.
8. Affadavit of anti ragging and motorised vehicle.
Powered By DWD-DTU, Copyright 2014.
