APPLICATION FOR ADMISSION TO THE

BOMBAY Y.M.C.A. HOSTEL

To TO BE FILLED IN BY YMCA OFFICE

The Secretary Arrival Register Serial No._________________
______________________ Branch Room No. Allotted______________________
Bombay YMCA Membership No._______________________
Amount Received Deposit________________
Advances_____________________________
Cash Receipt No./ Date__________________
Dear Sir,
Being a member of the Bombay YMCA, I hereby request for accommodation in the Hostel situated at
____________________________________________________________________________________
for a period of ____ days/ weeks/ Months starting from ______________ till _____________________
Full name of applicant (in block letters) ____________________________________________________
____________________________________________________________________________________
Age____________ Nationality ___________________ Passport No. if any________________________
Full permanent house address: ___________________________________________________________
__________________________City: _____________ State: _______________ Pin code: _____________
Email Address: ___________________________________________ Mobile: ______________________
Occupation: ______________________________: Office Tel No: ____________________
Office Address: _______________________________________________________________________
_________________________ City: _____________ State: _______________ Pin code: _____________
Particulars of previous stay in any YMCA Hostel _____________________________________________
I have read and understood the Hostel Rules of the Bombay YMCA and agree to be bound by the Rules
of the time being in force and all additions, alterations, amendments, revocations and the attachments
thereof and all other rules, regulations and by-laws which might from time to time be made.
Yours faithfully,

Date: ___________________ Signature of Applicant

Signatures and addresses of two responsible persons willing to certify that the applicant is suitable for
admission to the hostel and guarantee good conduct and behavior and observance of the Rules and
Regulations of the Hostel by the applicant.
Name Address Signature

Date: ________________________ Signature of Secretary:

To

The Secretary
_______________________ Branch
Bombay YMCA

Dear Sir,

1. I hereby agree to abide by the rules and regulations of the Hostel contained in the Hostel Rule of
Bombay YMCA which I have read.

2. I hereby consent and hereby authorize Branch Secretary to take such action as may be available
to him or as he may be advised for enforcement and / or implementation of the rules and
regulations and objects of the hostels.

3. I hereby further agree not to obstruct and not to prevent the Branch Secretary from
implementing the rules and regulations of the hostel.

Yours faithfully,

Date: _________________ Signature of Applicant