NATIONAL CENTRE OF EXCELLENCE IN GEOLOGY UNIVERSITY OF PESHAWAR Peshawar-25120, KPK, Pakistan Phone: +92-91-9216427; 9216429 Fax: +92-91-9218183 Web: http://nceg.upesh.edu.pk/ RESIDENCE IN HOSTELS IS A PRIVILEGE NOT A RIGHT Session: 2 0 Program: (Geology/Geophysics/Environmental/Geospatial/any other): Degree: (MS/M.Phil/PhD) Name: (Block Letters) Father Name: (Block Letters) Date of Birth: C.N.I.C No: - - (Attach copy) Gender: Male / Female ADDRESS Residential: Phone (Home): Mobile # Permanent: Emergency 1: Father/Guardian Name: Mobile No. Telephone No. Address: Emergency 2: Next of Kin/Family Member/Friend Name: Mobile No. Telephone No. Address: FOR HOSTEL USE ONLY Allotted Hostel Name: Warden’s Remarks: Telephone Verification from Guardian: D:\106750561.doc Allotted Room No. GRADUATE ADVISOR OFFICE It is verified that the information given by the applicant is correct. He/ She is a regular student and is recommended for hostel accommodation on the condition that he/she shall abide by all the hostel rules and regulations. 1. Date of Admission _________________ 2. Extension if any: ______________________ 3. Progress: _________________________ 4. Date of Completion: ___________________ Superintendent (Academics) Graduate Student Advisor UNDERTAKING I, Mr. ___________________________________ S/D/W of __________________________ student of ________________________________ National Centre of Excellence in Geology, University of Peshawar, affirm that the information given above is correct and, solemnly, undertake that I, to the best of my ability during stay in the hostel, shall abide by the NCEG hostel rules and regulation. 1. I shall strictly follow hostel rules as prescribed by NCEG. 2. I Shall not allow outsiders to stay in my place or with me. 3. NCEG authorities may place lock/open and transfer my belongings to store in case found breaking the rules or required for any purpose. 4. I shall pay all the utility bills of my room and other charges of hostel. 5. No outsider is allowed except next of kin/Guardian; who can only stay for one night on payment of Rs.200/I further undertake and affirm on oath that I shall neither indulge in any sort of activity prejudicial to the good order and discipline of the NCEG nor any politics whatsoever, failing which I shall not object to any disciplinary action taken against me. __________________ Signature of Applicant PARENT’S GUARDIAN CERTIFICATE I, Mr./Ms. ____________________________________ certify that my son/ daughter/ ward is applying for hostel accommodation on the Campus of NCEG with my permission and undertake that I will be responsible for his/ her good behavior during his/her stay in the NCEG and will accept all decision of the NCEG authorities in matters of hostel admission and discipline. I further undertake that he/ she who has furnished the above undertaking shall comply with it in case he/ she violates the same, he/ she shall face punishment under the NCEG Regulations. _________________________ Signature of Parent’s Guardian C.N.I.C No: - - (Attach copy) FOR OFFICE USE ONLY Accounts Section Authority Warden/Hostel Incharge Received Rs. _________________ Hostel Accommodation Verified that all necessary vide Bank DS No. ____________ Recommended / documents completed. date __________ (attached). Not recommended. Allotted Room No. _____________ Supdt (A/Cs) _____________________ A/Cs Officer Graduate Student Advisor ______________ Warden/Incharge Approved: ____________ Director D:\106750561.doc