UP NISMED Hostel Reservation Form
Last Name *
Your answer
First Name *
Your answer
Middle Initial
Your answer
Gender *
Birth Date *
Your answer
Address *
Your answer
Nationality *
Your answer
Telephone/Mobile Number *
Your answer
Email Address *
Your answer
Check-in Date *
MM
/
DD
/
YYYY
Check-out Date *
MM
/
DD
/
YYYY
Number of Rooms *
Your answer
Room Type *
Note:
For Type B and C rooms, only guest with the same gender are allowed to occupy the same room with shared toilet and bath. This is strictly enforced for health and safety reasons.

Check-in time is at 2:00PM. Check-out time is at 12:00NN. The hostel observes an 11:00PM curfew. It re opens at 5:00AM.
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