UCEA HOSTELS Hostel Accommodation Willingness Form
For Contact (Between 10.00 A.M. to 4.00 P.M)
Boys Hostel : Mr. G. Mani,
Deputy Warden(Boys)
9842527788
Girls Hostel: Dr. R. Ezhilarasi,
Deputy Warden(Girls)
7502420066
* Required
1. Applicant Name(In Capital letter)
*
Your answer
2. Registration No./TNEA No(First Year)
*
Your answer
3. Hostel ID
Your answer
4. Department
*
Your answer
5. Year of Study
*
Your answer
6. Gender
*
Male
Female
7. Residential Address:
*
Your answer
8. Mobile No. (Student)
*
Your answer
9. E-Mail ID (Student)
*
Your answer
10. Father's Name
*
Your answer
11. Parent's Mobile No.
*
Your answer
12. Mention the Date of Hostel Accommodation required
*
MM
/
DD
/
YYYY
13. Distance from Institution to Residence
*
Your answer
14. Any Specific Reasons for Hostel Requirement
*
Your answer
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