भारतीय सूचना प्रौद्योगिकी संस्थान, पुणे

Indian Institute of Information Technology, Pune

(An Institute of National Importance by an Act of Parliament)
Survey No. 9/1/3, Ambegaon Budruk, Sinhagad Institute Road, Pune – 411041

HOSTEL APPLICATION FORM

(To be filled in by the applicant in his/her own handwriting clearly and carefully)

For office Use only

Recent
Passport
Hostel Allotted:………………………………………………………….. size colour
Room No. …………………. Bed No………………… Photo
Fee Payment Details
Amount (INR) Date Ref No.
1.

2.

Staff Academic section Warden/ Competent Authority

Sir,
I wish to apply for providing accommodation in any Hostel (Including any residential flat if converted into hostel) managed by
HMC, IIIT Pune for the academic year 2022 - 2023
I hereby agree that I have read and will abide by the Rules and Regulations of the hostel in force from time to
time. I furnish the following particulars :
PERSONAL DATA
1) Full Name (with Surname) ________________________________________________________________________

2) Category (Gen/ SC/ ST/ OBC/Divyang) 3) Gender: Male/ Female

4) Date of Birth ___________________________

5) Name of Programme with Specialisation ( If any): _________________________________________________________

6) Hostel Fee Paid Rupees: ………………………………………(Receipt enclosed) for period: ……………..to……………….

7) Permanent Address ___________________________________________________________________________

_______________________________________________________________(Email)___________________________

Tel. No. (M) _______________________________________________ (R)_________________________________

I hereby submit to the disciplinary jurisdiction of the Director and the other Officers and Authorities of the Institute and
shall observe and abide by the rules of the Institute in that behalf. I hereby declare that all statements made in this
application are true, complete, and correct to the best of my knowledge and belief. I understand that in the event of any
information being found false / incorrect, my candidature is liable to be cancelled or rejected and fees paid by me
forfeited.

Date: Signature of the applicant with Name

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 FAMILY BACKGROUND

1) Full name of the Parent/Guardian (With mobile no.)________________________________________________

2) Relationship __________________________________________________________________________________

3) Occupation _____________________________________________ Designation ____________________________

4) Office Address _________________________________________________________________________________

Email: _________________________________ Tel. No. (with STD Code) __________________________________

NEAREST LOCAL GUARDIAN

5) Name and address of contact person who should be contacted (in case of emergency)

1) Name _____________________________________________________________________________________

Address ______________________________________________________________________________________

______________________________________________ Tel. No. (Mob / Res) ______________________________

2) Name ____________________________________________________________________________________

Address ______________________________________________________________________________________

______________________________________________ Tel. No. (Mob / Res) ______________________________

I request you to admit my ward Mr. / Ms. ______________________________________ ________________________

to the Hostel / Residential Flat. I give an undertaking that he / she has read and will observe all Rules & Regulation of
the Hostel. In case of any type of complaint, student will follow the Grievance Redressal process of the Institute and no
direct representation will be made to higher authorities/ any authorities’ outside the Institute, without exhausting the
prescribed channel of representation. In case of any such event, the student shall be liable for disciplinary action.

Yours faithfully

Date : Signature of the Parent / Local Guardian

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 RULES AND DISCIPLINE FOR ADMISSION IN HOSTEL
1) Admission is open to full time students of IIIT Pune. Preference will be given to out-station students.
2) The Hostel Mess is compulsory for all the hostel residents.
3) The application form completed in all respects should be submitted to the Office of the Academic Section on any
working day during office hours.
4) Admission to the Hostel will be cancelled if incomplete or false information is furnished.
5) Applicants who are offered admission in the Hostel will be informed by letter/email or their names will be put up on
our website (3 days prior to start the course). They will have to take up the accommodation by the stipulated date,
failing which his/her admission will be cancelled and the seat will be offered to another student.
6) Admission will be valid for one academic year only (10 months from the date of commencement of course). 6)
Students will be required to vacate the room within 3 days on completion of the scheduled examination each year,
subject to adjustment of examination dates fixed by the appropriate Authority of IIIT PUNE.

7) Students are required to give their consent about continuing the Hostel facilities in the next year, when asked by
the authorities.
8) Hostel fee for the next academic year is required to be paid in the month of February to April.
9) HMC/ IIIT Pune reserve its right to cancel admission of undeserving students without giving any reason.
10) HMC/ IIIT Pune reserve its right to increase the hostel fee, if necessary. 11) HMC/ IIIT Pune will not be responsible

for any mishap.

12) Student residing in the Hostel managed by HMC shall strictly observe all the Rules and Regulations in force from
time to time. Breach of rules / regulations may invite rustication / fine/ disciplinary action.
13) During their stay in the Hostel, they will be under the control of the Officials of HMC / WARDEN.
14) Smoking, consumption of alcoholic drinks, drugs and spitting is strictly prohibited in the hostel premises. Strict
action will be taken against defaulter (as per rule).
15) No guest or visitor of the inmate will be permitted to visit rooms. Visitors and guests should be received in the
Visitors room or Reception area only between 9.00 a.m. to 9.00 p.m.
16) Every student shall be in his / her hostel by 11.00 p.m. for boys and 9 pm for girls, If he / she has to stay out after
the said timing owing to any special reason, he / she must obtain prior permission from the HMC / Warden. The
application for leave of absence from the hostel shall be made in writing thru HoD to the HMC and her permission
shall be obtained. Late entry without prior permission will invite penalty / rustication. Please Note that, ‘Night out’
is allowed only to visit local guardian or relatives staying in Pune. A maximum of 4 ‘Night outs’ will be allowed in a
month. The students who are taking night outs are not allowed to enter the hostel after 11 pm for boys and 9 pm
for girls on the respective day till next day morning 7 am of taking the night out. Students have to submit a copy of
the night out application (duly signed by the hostel authorities) to the security guard and also
need to enter the time of leaving the hostel on the night out register.
17) No students shall use the service of a hostel servant for personal work even on payment. He/she shall also not
bring any servant from outside even temporarily.
18) Students will not enter rooms of other students without permission of the inmates. Students should not go to other
student’s room after 11.00 p.m. in the night.
19) Every case of illness and accident must be reported immediately to the Warden of the hostel.
20) No functions or celebrations shall be organized except with the permission of the Registrar/ Director.
21) Resident students are not permitted to convene any meeting of any sort under any circumstances anywhere in the
Hostel premises without the prior permission of the Registrar or the Management.
22) No poster etc. should be put up anywhere, either in rooms or lobbies.
23) Students are not allowed to play any kind of sports in the room.

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24) Throwing of water, colour etc. on one another and on the walls / property of the hostel is strictly prohibited. 25)
Students suffering from any contagious disease will not be allowed to stay in the hostel. Decision of the Registrar
in this regard will be final and binding.
26) Allotment of the room, furniture etc. will be entirely at the discretion of the HMC/ Warden/ Appropriate Authority
and no complaint in this regard will be entertained.

27) Every student shall keep the room allotted to him clean and neat. He / She shall take proper care of the furniture and
fixtures handed over to him / her. The hostel authorities have the right to enter and inspect the rooms at any time,
even in the absence of students.
28) All matters relating to differences among students and complaints about the hostel servants shall be brought to the
notice of the Chairman, HMC/ Warden, who will take such action as may be necessary. No police complaint
will be lodged by the students before taking prior permission from the Registrar.
29) Students are expected to switch off the lights and fans in their rooms every time they go out and take precautions
to economies electricity consumption. Cooking in the room and use of electrical appliance like
induction plate, Heater, etc are strictly prohibited. Violation will invite penalty / rustication.
30) Charges for any damages to the property as well as to the furniture and fixtures caused by a student/students
negligence will be recovered from the student/students staying in the said flat / room.
31) Student should not drive nails, screws etc. into the wall or doors. No repair shall be done by the students
themselves. They should approach the Registrar who will arrange for repairs.
32) Hostel is meant only for the use of bonafide students of that particular hostel. Visitors are not allowed to enter any
room, without authorisation.
33) The Hostel Authorities did not hold themselves responsible for the safe custody of the property of the students
staying in the hostel. Students should provide their own locks and should take proper care of their belongings.
They should not leave the key of the room anywhere around. IIIT PUNE will not be responsible for the loss of
personal belongings of the students.
34) All the facilities including additional Magazines, Newspaper, Internet etc., misused, shall be discontinued without
given any notice and disciplinary action will be taken against the students involved.
35) Before leaving the hostel, a student must pay all dues and hand over the charges of rooms and other material in
satisfactory condition to the Registrar.
36) If any student is found misbehaving and misconducting himself, he/she will be expelled from the hostel immediately
and the fees paid by him / her will be forfeited.
37) Permission must be sought and obtained, if night outs (only for local guardian and parent’s house) are desired
from hostel in charge/ warden, 1 day in advance.
38) No music system is allowed in hostel.
39) Any complaint (indecent behaviour/noisy) from the neighbours/society will result in severe action.
40) Hostel is required to be vacated with luggage in every summer vacation.
41) Ragging is strictly prohibited inside the hostel premises.
42) Admission to Hostel shall be governed by the Rules & Regulations of IIIT PUNE as amended from time to time.

DECLARATION TO BE SIGNED BY THE STUDENT

I have read all the Rules and Regulations of the Hostel. I hereby agree to abide by the rules and regulations of the
Hostel in force from time to time. I am liable for disciplinary action in case of any breach.

Date: ______________________ Signature of Student Signature of Parent

(Name and Address) (Name and address)

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