{# <!--
    College header SJCC  FORM FOR LADIES HOSTEL SJU (LADIES)
--> #}
{% set markDivwidth = 50  %}
{% if ('eleventhMarkEntry' in allFormFields or 'ELEVENTH' in allFormFields) %}
	{% set markDivwidth = 100/3  %}
{% endif %}
<html>
	<head>
		<style>
			td {
				line-height: 24px;
				padding-left: 10px;
				font-size: 14px;
			}
		</style>
	</head>
	<body class='page'>
		<div>
			<div class='sub-page'>
				<table cellspacing='0' cellpadding='0' class='table table-bordered padding-print ' width='100%' style='color:black;'>
					<tr>
						<td colspan="3" align='center' width="100%">
							{% if form.id in ['6','9'] %}
							<img style='width: 100%;' src="{{college.url}}/libcommon/images/college/{{college.collegeCode}}/ladies_hostel_banner.png">
							{% else %}
							<img style='width: 100%;' src="{{college.url}}/libcommon/images/college/{{college.collegeCode}}/hostel_banner.png">
							{% endif %}
							
						
						</td>
						{# <td width="70%" align="center">
							<div align='center' style="">
								<div style="font: bold 20px 'Times New Roman';margin-top: 0px;margin-bottom: 4px">{{college.collegeName|upper}}
									{{college.autonomous?( college.autonomous|slice(0, 2)|upper):''}}{{college.autonomous?(college.autonomous|slice(2)|lower  ):''}}</div>
							</div>
							<div align='center'>
								<p style='margin: 0 0 0px;font-size: 12px;'>{{college.collegeAddress}}
									{{college.collegeAddress1}}
									{{college.collegeAddress2}}</p>
								<p style='margin: 0 0 0px;font-size: 12px;'>{{college.collegePhone}}</p>
								<p style='margin: 0 0 0px;font-size: 12px;'>{{college.collegeWebsite}}</p>
								<p style='margin: 0 0 0px;font-size: 12px;'>{{college.collegeEmail}}</p>
							</div>
						</td>
						<td width="10%">
							<br>
							<img style='float: right;width: 85px;height: 100px;' src="{{student.studentPhoto}}" alt='' class='img-responsive'/>
						</td> #}
					</tr>
                    <tr>
                        <td align="left"><h2 style='color:red;'><b>{{student.applicationNo}}</b></h2></td>
                    </tr>
					<tr>
						<td colspan='3' align='center'>
							<div align='center' style="font-size: 13px;width: 400px;">
								<h3>{{form.name}}</h3>
							</div>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>Full Name
										</b>
									</td>
									<td width='25%'>
										:
										{{student.studentFirstName|upper}}
									</td>
									<td width='20%'>
										<b>Date of Birth
										</b>
									</td>
									<td width='25%'>
										:
										{{student.dateOfBirth}}
									</td>
								</tr>
								<tr>
									<td>
										<b>Age</b><br>
									</td>
									<td>
										:
										{{student.age}}
									</td>
									<td>
										<b>Academic Year
										</b>
									</td>
									<td>
										:
										{{student.applicationYear}}
									</td>
									
								</tr>
								<tr>
									<td>
										<b>Course Name</b><br>
									</td>
									<td>
										:
										{{student.batchCourseName}}
									</td>
									<td>
										<b>Mobile
										</b>
									</td>
									<td>
										:
										{{student.countryCode}} {{student.studentMobile}}
									</td>
								</tr>
								<tr>
									<td>
										<b>WhatsApp Number
										</b>
									</td>
									<td>
										:
										{{student.whatsappNo}}
									</td>
									<td>
										<b>Religion
										</b>
									</td>
									<td>
										:
										{{student.religion}}
									</td>
								</tr>
								<tr>
									<td>
										<b>State/District
										</b>
									</td>
									<td>
										:
										{{student.stateDistrict}}
									</td>
                                    <td>
                                        <b>Batch</b>
                                    </td>
                                    <td>
                                        : {{student.batchName}}
                                    </td>
								</tr>
                                <tr>
                                </tr>
							</table>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<b>Parent's Details</b>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>
											Father's Name</b>
									</td>
									<td width='25%'>:
										{{student.fatherName}}</td>
									<td width='20%'>
										<b>
											Mother's Name</b>
									</td>
									<td width='25%'>:
										{{student.motherName}}</td>
								</tr>
								<tr>
									<td width='20%'>
										<b>
											Father's Mobile No</b>
									</td>
									<td width='25%'>:
										{{student.fatherMobileCountryCodeId}} {{student.fatherMobileNo}}</td>
									<td width='20%'>
										<b>
											Mother's Mobile No</b>
									</td>
									<td width='25%'>:
										{{student.motherMobileCountryCodeId}} {{student.motherMobileNo}}</td>
								</tr>
										<tr>
									<td width='20%'>
										<b>
											Father's Annual Income</b>
									</td>
									<td width='25%'>:
										{{student.fatherAnnualIncome}}</td>
									<td width='20%'>
										<b>
											Mother's Annual Income</b>
									</td>
									<td width='25%'>:
										{{student.motherAnnualIncome}}</td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<b>Family Info</b>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-2 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>Name</b>
									</td>
									<td width='25%'>:
										{{student.name1}}</td>
									<td width='20%'>
										<b>Relation</b>
									</td>
									<td width='25%'>:
										{{student.relation1}}</td>
								</tr>

								<tr>

									<td width='20%'>
										<b>Mobile Number</b>
									</td>
									<td width='25%'>:
										{{student.mobileNumber1}}</td>
									<td width='20%'>
										<b>Email ID</b>
									</td>
									<td width='25%'>:
										{{student.emailId1}}</td>
								</tr>
							</table>
							{# <table class='table table-bordered m-b-2 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>Name</b>
									</td>
									<td width='25%'>:
										{{student.name2}}</td>

									<td width='20%'>
										<b>Relation</b>
									</td>
									<td width='25%'>:
										{{student.relation2}}</td>
								</tr>
								<tr>
									<td width='20%'>
										<b>Mobile Number</b>
									</td>
									<td width='25%'>:
										{{student.mobileNumber2}}</td>
									<td width='20%'>
										<b>Email ID</b>
									</td>
									<td width='25%'>:
										{{student.emailId2}}</td>

								</tr>
							</table>
							<table class='table table-bordered m-b-2 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>Name</b>
									</td>
									<td width='25%'>:
										{{student.name3}}</td>
									<td>
										<b>Relation</b>
									</td>
									<td width='25%'>:
										{{student.relation3}}</td>

								</tr>
								<tr>

									<td width='20%'>
										<b>Mobile Number</b>
									</td>
									<td width='25%'>:
										{{student.mobileNumber3}}</td>
									<td width='20%'>
										<b>Email ID</b>
									</td>
									<td width='25%'>:
										{{student.emailId3}}</td>

								</tr>
							</table>
							<table class='table table-bordered m-b-2' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>Name</b>
									</td>
									<td width='25%'>:
										{{student.name5}}</td>

									<td width='20%'>
										<b>Relation</b>
									</td>
									<td width='25%'>:
										{{student.relation4}}</td>
								</tr>
								<tr>
									<td width='20%'>
										<b>Mobile Number</b>
									</td>
									<td width='25%'>:
										{{student.mobileNumbe4}}</td>
									<td width='20%'>
										<b>Email ID</b>
									</td>
									<td width='25%'>:
										{{student.emailId4}}</td>
								</tr>
							</table> #}

						</td>
					</tr>
					<tr>
						<td colspan="3">
							<b>Permanent Address</b>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>
											Address Line 1</b>
									</td>
									<td width='25%'>:
										{{student.permAddressLine1}}</td>
									<td width='20%'>
										<b>
											Address Line 2</b>
									</td>
									<td width='25%'>:
										{{student.permAddressLine2}}</td>
								</tr>
								<tr>
									<td>
										<b>City</b>
									</td>
									<td>:
										{{student.permCity}}</td>
									<td>
										<b>PIN</b>
									</td>
									<td>:
										{{student.permPin}}</td>
								</tr>
								<tr>
									<td>
										<b>Country</b>
									</td>
									<td>:
										{{student.permCountry}}</td>
									<td>
										<b>State</b>
									</td>
									<td>:
										{{student.permState}}</td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<b>Guardian Address</b>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>
											Address Line 1</b>
									</td>
									<td width='25%'>:
										{{student.guardianAddressLine1}}</td>
									<td width='20%'>
										<b>
											Address Line 2</b>
									</td>
									<td width='25%'>:
										{{student.guardianAddressLine2}}</td>
								</tr>
								<tr>
									<td>
										<b>City</b>
									</td>
									<td>:
										{{student.guardianCity}}</td>
									<td>
										<b>PIN</b>
									</td>
									<td>:
										{{student.guardianPin}}</td>
								</tr>
								<tr>
									<td>
										<b>Country</b>
									</td>
									<td>:
										{{student.guardianCountry}}</td>
									<td>
										<b>State</b>
									</td>
									<td>:
										{{student.guardianState}}</td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td>
							<br>
						</td>
					</tr>
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 ' style='border:1px solid black;' width='100%'>
								<tr>
									<td width='20%'>
										<b>
											Hostel Preference</b>
									</td>
									<td width='25%'>:
										{{student.hostelId}}</td>
									<td width='20%'>
										<b>
											Room Preference</b>
									</td>
									<td width='25%'>:
										{{student.roomPreferenceId}}</td>
								</tr>
								<tr>
									<td>
										<b>Medical Reason if any</b>
									</td>
									<td>:
										{{student.medicalReasonIfAny}}</td>
									<td>
										<b>Reasons to join the Hostel (To be compulsorily filled in)</b>
									</td>
									<td>:
										{{student.reasonsToJoinTheHostel}}</td>
								</tr>
							</table>
						</td>
					</tr>
					
					<tr>
						<td colspan="3">
							<table class='table table-bordered m-b-0 print-table-border' style='border:1px solid black;' width='100%'>
                            <tr>
						<td align="center" colspan="3"><h3>Consent Form</h3></td>
					</tr>
								<tr>
									<td>
									
										<span style="line-height: 25px; text-align: justify;">
											{% if form.id in ['6'] %}
												I <b>{{student.studentFirstName}} </b>hereby confirm that I have read, understood and accept all the rules and regulations of St Joseph's University Gents Hostel, Bengaluru for my admission into the said hostel. I will pay the entire hostel fees before coming to the Hostel. I will not ask for reimbursement of any fees paid towards the hostel in case I want to vacate the hostel either before or during the academic year. I agree not to indulge in groupism of any type and would live in harmony with others in the hostel. I understand that smoking and consumption of alcohol, drugs and other objectionable material in the hostel is strictly prohibited, and I will abstain from possession, usage and consumption of such material both within the hostel and outside the hostel. In case of violation, I will be liable for severe penalties and punishments for indulging in such acts. I declare that indulgence in any anti-institutional or anti-social activity in the hostel is highly punishable and I will be liable for severe penalties and punishments for indulging in such acts. I declare that I am physically and medically fit to live in the hostel. I also declare that every information about my being medically/psychologically unfit in any degree or manner has been brought to the information of the hostel authorities at the time of applying for hostel accommodation. I will not hold the management, college authorities, or the hostel authorities responsible for any consequence which will be a result of my non-disclosure. I undertake to conduct myself as a diligent student within the hostel and in the vicinity and not misbehave in any manner including using inappropriate language, physical tiffs and fights with other inmates / employees / and others in the hostel premises and outside. I agree not to cook, not to use electric and electronic gadgets in the hostel rooms. If found doing so I will accept the penalty and handover the gadgets with immediate effect to the Director/warden. (Students are permitted to have laptops and mobile phones). I will not cause any damage whatsoever, including defacing the property of the hostel and understand that I will be liable for penalties and punishments for doing so. I accept to stay within the hostel premises by the stipulated time and will not stay out without proper prior permission from the concerned authorities. I will keep my room clean and in the same condition that was given to me and will not damage any furniture or appearance of room and will agree to pay the fine if done so. I will accept the room allotted to me and will not ask for any change of either room or roommate once the appointment is finalised. Finally, I agree to abide by all the rules and regulations of the institution with regard to my stay at the hostel which may be framed from time to time and accept the decision of the management in all respects as final and binding on me for compliance.
											{% else %}
												I
												<b>{{student.studentFirstName}}</b>
												hereby confirm that I have read, understood and accept all the rules and regulations of St Joseph's University Gents Hostel, Bengaluru for my admission into the said hostel. 
												I will pay the entire hostel fees before coming to the Hostel. 
												I will not ask for reimbursement of any fees paid towards the hostel in case I want to vacate the hostel either before or during the academic year. 
												I agree not to indulge in groupism of any type and would live in harmony with others in the hostel. 
												I understand that smoking and consumption of alcohol, drugs and other objectionable material in the hostel is strictly prohibited, and I will abstain from possession, usage and consumption of such material both within the hostel and outside the hostel. In case of violation, I will be liable for severe penalties and punishments for indulging in such acts. 
												I declare that indulgence in any anti-institutional or anti-social activity in the hostel is highly punishable and I will be liable for severe penalties and punishments for indulging in such acts. 
												I declare that I am physically and medically fit to live in the hostel. I also declare that every information about my being medically/psychologically unfit in any degree or manner has been brought to the information of the hostel authorities at the time of applying for hostel accommodation. I will not hold the management, college authorities, or the hostel authorities responsible for any consequence which will be a result of my non-disclosure. 
												I undertake to conduct myself as a diligent student within the hostel and in the vicinity and not misbehave in any manner including using inappropriate language, physical tiffs and fights with other inmates / employees / and others in the hostel premises and outside. 
												I agree not to cook, not to use electric and electronic gadgets in the hostel rooms. If found doing so I will accept the penalty and handover the gadgets with immediate effect to the Director/warden. (Students are permitted to have laptops and mobile phones). 
												I will not cause any damage whatsoever, including defacing the property of the hostel and understand that
												I will be liable for penalties and punishments for doing so. 
												I accept to stay within the hostel premises by the stipulated time and will not stay out without proper prior permission from the concerned authorities. 
												I will keep my room clean and in the same condition that was given to me and will not damage any furniture or appearance of room and will agree to pay the fine if done so. 
												I will accept the room allotted to me and will not ask for any change of either room or roommate once the appointment is finalized. 
												Finally, I agree to abide by all the rules and regulations of the institution with regard to my stay at the hostel which may be framed from time to time and accept the decision of the management in all respects as final and binding on me for compliance.
										{% endif %}
										</span>
									</td>
								</tr>
								<tr>
									<td style="padding-left: 0%;">
										<table class='table' width='100%'>
											<tr>
												<br>
												<td colspan="1" align="left">
													<b>
														Place:</b>
												</td>
											</tr>
											<tr>
												<td align="left">
													<b>Date:</b>
												</td>
												<td align="right">
													<b>Signature of the Student</b>
												</td>
											</tr>
										</table>
									</td>
								</tr>
								<td>
									I ................................................................................
									assure that my ward will abide by all the rules and regulations of the hostel. I have no objection if my ward is expelled from the hostel for violating the rules of the hostel.
								</td>
							</tr>
						</td>
					</tr>
					<tr>
						<td style="padding-left: 0%;">
							<table class='table' width='100%'>
								<tr>
									<td colspan="1" align="left"><br>
										<b>
											Place:</b>
									</td>
								</tr>
								<tr>
									<td align="left">
										<b>Date:</b>
									</td>
									<td align="right">
										<b>Signature of the Parent/Guardian</b>
									</td>
								</tr>
							</table>
						</td>
					</tr>
					<tr>
						<td align="center" style="padding-top: 8px;">
							<h4><br>
								SUBMIT THIS FORM AFTER FILLING ALL THE DETAILS TO THE HOSTEL DIRECTOR ALONG WITH THE PHOTOCOPY OF COLLEGE FEE RECEIPT. INCOMPLETE FORMS WILL BE REJECTED.</h4>
						</td>
					</tr>
					<tr></tr>
				</body>
			</html>
		</table>
	</body>
</html></td></tr></body></html></td></tr></body></html></table> </div></body></html></div></body></html>
