CENTRAL UNIVERSITY OF KERALA (Established by the Parliament of India under the Central University Act, 2009)

Thejaswini Hills, Periye, Kasaragod District– 671 316. Kerala, India. www.cukerala.ac.in

Application for Accommodation in Hostels Application to be submitted by students at the time of admission to PG programme for hostel accommodation, to be submitted to Dean Student’s Welfare through the Head of the Department 1 2

3 4 5 6 7 8 9 10

Name of the Student (In capital Letters) Address with District and State Contact Phone No. & E-mail Id Gender Category Date of Birth Programme of study Department Admission No. (if available) CUCET Score Remarks of the Head of the Department

GEN/OBC/SC/ST/Differently Abled

Undertaking by the student The information furnished above is correct to the best of my knowledge and known facts. I request you to kindly grant me a suitable accommodation in the University Men’s/Women’s hostel. I am aware that hostel admission is not a right of every student admitted to Central University of Kerala. Place: Date:

Signature of Student

New Hostel Application form.pdf

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