Charkos Group of Institutions

HOSTEL APPLICATION FORM FOR ADMISSION

Application Number:

Academic Year:

Name of the Candidate (In Block Letters):

Date of Birth:

Drop file here or click to upload

Age

Gender

Male

Female

Marital Status

Single

Married

Course

Year of Study

Date of Admission

Contact No. of the Candidate

Name of the Parent / Guardian

Parent / Guardian Tel. No.

Parent / Guardian Tel. (Res)

Parent / Guardian Tel. (Off)

Parent / Guardian Fax

Parent / Guardian Email

Name of the Local Guardian

Local Guardian Tel.

Local Guardian Fax

Local Guardian E-mail

Address for Corresponding

Corresponding Tel.

Corresponding Fax

Corresponding E-mail

Whether the candidate has any medical history of ailments(If yes, please state briefly and attach medical certificates)

Yes