Sir/Madam,
I wish to apply for accommodation in any Hostel/Residential Flats (converted into hostel) managed by SVKM's NMIMS

I hereby agree that I have read and will abide by the Rules and Regulations of the hostel in force from time to time. I furnish the following particulars :

PERSONAL DATA :

1. Full Name *:


2. Residential Address *:


3. Email *:


4. Mobile No. *:


5. Residential Phone No. :


6. Date of Birth *:


7. Nationality *:


8. Program Name *:


9. College Name *:


10. Year *:

    I Year
2nd Year onwards Students need to apply hostel through student portal

11. State *:

    Select ANDAMAN & NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATTISGARH DADRA & NAGAR HAVELI DAMAN & DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU & KASHMIR JHARKHAND KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA MIZORAM NAGALAND ORISSA PONDICHERRY PUNJAB RAJASTHAN SIKKIM TAMIL NADU TELANGANA TRIPURA UTTAR PRADESH UTTARANCHAL WEST BENGAL


12. City *:


13. No. of Dose (Covid Vaccination) *:

    First Dose Second Dose

I declare that the information given above is true to the best of my knowledge. I agree that if any information furnished above found incorrect, my admission is liable to be cancelled.