Do you have any medical condition that requires the attention of the university?
SECTION B: PROGRAM INFORMATION
Name of program offered
Date of birth
Country of residence
Country of citizenship
SECTION C: EMERGENCY CONTACT
SECTION D: ACCOMMODATION PREFERENCE
I would prefer to share with:
Check in date
Check out date
Reminder: Please refer to the attached Rental and Tenure Options table for details. Hostel fee is to be paid on a monthly basis.
Please include with your application the RM500 booking fee for your off-campus accommodation.
Please take note that the booking fee is to be offset against the Total Payable once student move into the reserved accommodation. For payment method, please refer to the attached Information for Applicants.
GENERAL PRIVACY STATEMENT
The information collected on this form is to process your accommodation booking request. The information is processed in accordance with the Personal Data Protection Act (PDPA) 2010. It is only disclosed to third parties with your consent or to meet statutory obligations.
By signing this form, you agree to be subject to the Privacy Collection Notice of the University and have consented to the processing and disclosure of your personal data for the fulfilment of this contract.
SECTION E: DECLARATION
By ticking this box I confirm my accommodation booking, and agree to abide by the terms and conditions stated. I also acknowledge that I have read the Information for Applicants and certify that all information provided is true, accurate and complete. Together with this booking form, I include a sum of RM500.00 as payment in the form of
Please take note that you will be advised on your booking of accommodation by written confirmation within 5 working days.
Kindly make the booking fee payment (RM500) to:
Account Name: Hubridy Company
Bank Name: Maybank