Name:___________________ Room No:__________________

Photocopy of I.C

Signature

Relationship: __________________________
H/P No________________________
Car No. Plate:_________________

Photocopy of I.C

Signature

Relationship: _________________________
H/P No_______________________
Car No. Plate:________________

Authorization to Fetch Children

__________________,/____________
I ____________________________________ would like to authorize the following person
to fetch my son / daughter ________________________________from hostel on my behalf.

1. _______________________________ I.C.No:_____________________________
2. _______________________________ I.C.No:_____________________________
3. _______________________________ I.C.No:_____________________________
4. _______________________________ I.C.No:_____________________________
5. _______________________________ I.C.No:_____________________________
6. _______________________________ I.C.No:_____________________________
7. _______________________________ I.C.No:_____________________________
8. _______________________________ I.C.No:_____________________________

9. _______________________________ I.C.No:_____________________________
10. _______________________________ I.C.No:_____________________________

Thanks.

____________________________
/ Parent/Guardian
I.C.No:____________________________
Date:____________________________________

: 18
PS: Those under 18 years old are not allow to sign out hostel student.