LincHostel | Comprehensive Hostel Application Form

Account Details for Payment

Bank Name

Zenith Bank

Account Number

1311150112

Account Name

Lincoln ODL LTD (GOperation)

Application System Status

Daily communication quota status

Emails Remaining Today 500 of 500 left

Comprehensive Hostel Application Form

Student Info

Parent/Guardian

Medical Report

Documents

Declaration

1. STUDENT INFORMATION

Personal Details

Full Name *

Student ID *

Gender *

Date of Birth *

Phone Number *

Email Address *

Academic Details

Academic Year *

Amount Paid (₦) *

Intake *

Program *

Department *

Location & Address Details

Nationality *

State of Origin *

Local Government *

Home Address *

2. PARENT/GUARDIAN DETAILS

Parent/Guardian Information

Full Name *

Relationship *

Phone Number *

Email Address

Address *

Occupation Details

Occupation *

Workplace/Company

Emergency Contact

If different from parent/guardian above

Emergency Contact Name *

Phone Number *

Emergency Contact Address *

3. MEDICAL REPORT & HEALTH INFORMATION

Medical Conditions & Allergies

Medical Conditions Leave blank if none

Allergies Leave blank if none

Current Medications Leave blank if none

Dietary Requirements Leave blank if none

Health Details

Blood Group

Genotype

I have a disability or special needs

Disability Details

Smoking Status * Important for roommate matching

Vaccination Status

Health Insurance (NHIS/HMO)

Preferred Emergency Hospital

Physical Activity Restrictions

4. REQUIRED DOCUMENTS

Required Documents *

Passport Photo * Upload a clear passport-sized photograph (JPG, PNG, max 10MB)

Application Form Receipt * Receipt for ₦2,000 application form fee (max 10MB)

Hostel form fee * Receipt for hostel fee payment (max 10MB)

Additional Documents

Medical Report Recent medical examination report (max 10MB)

Admission Letter Copy of university admission letter (max 10MB)

Additional Information

Previous Hostel Experience

Why Choose Hostel Accommodation?

5. DECLARATION & SIGNATURES

Student Declaration

I, declare that:

All information provided in this application is true and accurate to the best of my knowledge.
I understand that providing false information may result in the rejection of my application or termination of accommodation.
I agree to abide by all hostel rules and regulations set by the institution.
I understand that hostel accommodation is subject to availability and approval.
I consent to the processing of my personal data for accommodation purposes.

Applicant Signature *

Date *

Parent/Guardian Consent

Parent/Guardian Declaration:

I confirm that I am the parent/guardian of the above-named applicant.
I give my consent for my child/ward to reside in the hostel accommodation.
I understand and accept the hostel rules and regulations.
I agree to be responsible for any damages caused by my child/ward.
I authorize the hostel management to take necessary medical action in case of emergency.

Parent/Guardian Signature *

Date *

Important Notes

Ensure all information is accurate before submitting.
After submission, you will receive an application number for tracking.
Your application will be reviewed by the hostel management team.
You will be notified via email and phone about the status of your application.
Keep your application number safe for future reference.

For any issues or questions, please contact the hostel management office.
Thank you for choosing LincHostel!