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Accommodation Form - 1 PDF

This document is an accommodation application form for a university. It requests information such as the student's name, contact details, nationality, religion, and date of birth. It asks the student to choose their first and second room preferences between an apartment or hall of residence, and provides the rental rates. Notes are provided about booking fees, refund policies, check-in dates, and that international students must stay in university accommodation for their first year. The student must declare that all information provided is correct before submitting the completed form.

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Chang Billy
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206 views2 pages

Accommodation Form - 1 PDF

This document is an accommodation application form for a university. It requests information such as the student's name, contact details, nationality, religion, and date of birth. It asks the student to choose their first and second room preferences between an apartment or hall of residence, and provides the rental rates. Notes are provided about booking fees, refund policies, check-in dates, and that international students must stay in university accommodation for their first year. The student must declare that all information provided is correct before submitting the completed form.

Uploaded by

Chang Billy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ACCOMMODATION

APPLICATION FORM

Passport Size
Photo

Programme Applied:
Intake:
(E.g - May 13)

A. Students Details
Name as in
IC / Passport:

(please underline surname)

Nationality:

Gender:

Male

Female

Religion:

IC / Passport No:
Date of Birth:

dd

Mobile:

mm

yy

E-Mail:
(For emergency contact purposes)

Parent/Guardian
Name:
Address:

Tel (O):

Tel (H):
Mobile:

B. Accommodation - Choice of Room


Please indicate your 1st and 2nd choice of room. Rental rate is charged by semester basis

1st CHOICE

( Tick ONE only)

2nd CHOICE

( Tick ONE only)

Apartment

Hall of residence

Room Type:

Room Type:

RM:

RM:

Apartment

Hall of residence

Room Type:

Room Type:

RM:

RM:

STARTER KIT (Optional)


1 each of the following: Pillow, pillow case, bedsheet, blanket & toilet roll
Remarks:

Age:

C. Please take note that:


1. In order to book or secure a room, a booking fee of RM150.00 (non-refundable) is required. The booking fee will be utilised to offset part of the
rental upon check in at the accommodation office. Alternatively, if you wish to confirm your choice of room, payment of rental for one semester
plus the refundable deposit is required.
2. Full refund of rental paid less an administration fee of RM150.00 will only be refunded to student provided the accommodation office is
informed in writing before 5.00pm on the first day of registration. The deposit will be refunded after deductions have been made (if any).
3. Application for choice of room is subject to availability.
4. Student must check in by the 3rd day of the registration week or rooms will be released.
5. All rooms are let out by semester and on a first-come-first serve basis and inclusive of water & electricity bill.
6. Students must vacate their rooms completely during semester break. Extended stay during semester break is available.
Please enquire at the accommodation office for rental rate.
7. Rental is subject to change.

Applicable for international students only:


All international students are required to stay in the universitys accommodation for the first year

D. Declaration
I declare that all information submitted on this application form is correct and complete. I understand that the university reserves the right to vary
or reverse any decision regarding admission made on the basis of incorrect or incomplete information.

Signature of Applicant

Date

E. For Office Use Only

Counselled by
Name:
Signature:
Date:

Application received by
Name:

Cash / Cheque No:


Receipt No:

Signature:
Date:

Application processed by

Amount Received:

RM

Balance Payable:

RM

Room No:

Name:
Signature:
Date:

Please submit the completed accommodation form together with student application form to:
NILAI UNIVERSITY
Marketing Department
No. 1, Persiaran Universiti, Putra Nilai, 71800 Nilai, Negeri Sembilan Darul Khusus, Malaysia
Tel: +60 6 850 2308 Fax: +60 6 850 1266 SMS: +6 012 628 1139 E-mail: [email protected]
Website: www.nilai.edu.my
KPT/JPT/DFT/US/N02 307215-P

V1-01-13

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