Application Form For Hostel Re-Admission

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APPLICATION FORM FOR HOSTEL RE-ADMISSION

(This form, together with the declaration, medical fitness certificate and proof of medical insurance,
must be submitted electronically to the Warden and Hostel Office by email.)

I, , am studying in ICT Mumbai for the


program. I belong to the Department
and work under the guidance of . I am a PhD research scholar
/ outgoing post-graduate researcher (2018-2020 batch). I am a hostelite and I was allotted Room No.
in Hostel No. before the lockdown. I wish to apply for re-admission to the
hostel from to . I am willing to pay hostel fees for the period
of my stay. I have permission from my Research Supervisor to resume my research work in the
laboratory. I am aware that limited hostel seats are currently available. I will stay only for the period
specified by the Warden / Hostel Office. I agree to these points stated below:

1. During re-admission, I shall not bring along with me any accompanying person inside the hostel.
If it is found that I have high fever, I may be denied entry. Upon re-admission, I will stay alone
inside a room (specified by the Hostel Office) for two weeks. I will compulsorily practise self-
isolation and not leave the hostel premises during this period.
2. After the completion of my two-week isolation period, I will agree if the Hostel office temporarily
shifts me to another room (if necessary) for accommodating newer students (who, in turn, will now
undergo compulsory two-week isolation). I will commence lab-work only after my two-week
isolation period is over.
3. I will always use mask and sanitizer; ensure social distancing; and practise cleanliness and hygiene.
If I develop any symptoms such as fever, dry cough, runny nose, sore throat, shortness of breath,
or loss of taste and smell, I will immediately report to the Warden / Hostel Office and seek medical
opinion from the hostel doctor.
4. I am aware that Warden / Hostel Office reserves the right to rearrange my hostel-number, room-
type, duration of stay in hostel, in-time (or reporting time in hostel at night) and number of students
per room to meet COVID-19 related safety requirements.
5. I am aware that C-mess will be made functional in the month of August. I will be provided with
morning breakfast, lunch and dinner from C-mess. I will compulsorily pay for the daily coupon
priced at Rs. 100/- until further notice is provided by the Hostel office.
6. I am aware that common areas such as playgrounds, courtyards, pavilion, gymnasium, indoor
sports room, TV room, reading room and study room will be closed till further notice.
7. I am aware that social gatherings / hostel fests / hostel sports / other hostel-related events will not
be permitted until further notice.
8. I am aware that Warden / Hostel Office reserves the right to deny / permit entry of staff, vendors,
visitors and guests inside hostel and mess premises.
9. I am aware that I may be permitted to go outside the campus only once a week (Thursday: 10 am
to 1 pm; only after completion of the self-isolation period).
10. I am aware that the guest room facility will not be available until further notice.
11. I shall avoid crowding inside the mess, hostel and campus.
12. In the unfortunate case of a COVID-positive patient inside the hostel, I will follow necessary
instructions issued by the Warden / Hostel Office.
13. I am aware that defaulters will face appropriate disciplinary action.

Signature: Date:
Name: Mobile:
Emergency Contact Numbers:

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