Registration Form

Form No. : 70

Shri Hirji Bhojraj & Sons CVO Jain Chhatralaya

426, Shradhanand Road, King Circle, Matunga (C.Rly.), Mumbai - 400 019.

Email Id: matungaboarding1915@gmail.com | Contact Number : 9833456403

Senior student hostel

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TO,
Hon. Secretary,

Respected Sir/ Madam

I kindly request you to grant me an admission in your hostel for academic year 20 to 20 I confirm that I have read all rules & regulations prescribed by your Institution. I hereby promise to follow rules and regulations which are in force at present as well as those which will be made in future.

Place:^*
Date:^*

Addhar Copy^*

Current Year Fee Reciept^*

(Before filling this form the student should read all the rules & regulations stated at the end of this form)

Name^*

Father’s Name^*

Grand Father’s Name^*

Surname^*

Village in Kutch :^*

Presently Residence at^*

Dist^*

State^*

Birth Date:^*

Marital Status:

Mob. Number:^*

E-mail:^*

4a)

Father/Guardian’s Name:^*

Mob. No:^*

Occupation:^*

Education Qualification :^*

Address:^*

Flat No: & Building Name:

Street:

Area:

Landmark:

Town:

City:

Pincode:

4b)

Guardian’s relation with Student:^*

4c)

Mother’s Name:^*

Her Education Qualification:

Mob. No:^*

Maternal Grand Father’s Name:

Her Maternal Village / Dist / State:

Have you Stayed in any other hostel ?:

Yes

If yes, in which year ?:

Name & Address:

Flat No: & Building Name:

Street:

Area:

Landmark:

Town:

City:

Pincode:

Reason for leaving that hostel:

Details About Studies.

I) Admission Required for which Std / Course:^*

II) Name of College / Institute you intend to join:^*

III) Last exam appeared / Passed:^*

Percentage / CGPA:^*

Name of college / Institute:^*

IV) Which degree / Course you want to persue & in which college / institute:^*

V) Do you intend to work along with studies ?:

VI) If Currently Working give detail’s:

If your parents are staying outside Mumbai, following details are to be submitted.

I) Name of a person for communication in Mumbai and your relationship:^*

II) His / Her address:^*

III) His / Her Mobile no. & E-mail id:^*

PAST EDUCATION DETAILS

Exam	Month & Year of Passing	Name & Place of School / College	Marks obtained	Out Of	Percentage % / CGPA	Attempts for Passing
SSC
11th
12th
1^st year
2^nd year
3^srd year
4^th year
^Other

Student’s Signature^*

Father / Mother / Guardian^*

I hereby accept the abovementioned rules & regulations and promise to obey & follow it in letter & spirit. Click here to read rules & regulations

I confirm that my son/ward has read the above rules & regulations. I further confirm that I do not have any objection to above rules & regulations. . Click here to read rules & regulations