APPLICATION FOR OVERSEAS STUDENTS HOUSING

No.
Name

TOHIR ZAINURI

Sex

MALE

Date of Birth

1981 yy 01 mm 28 dd

/ Nationality/Area

INDONESIAN

Religion

MOSLEM

Mobile Phone

+6282334058999

Passport No.
E-mail Address

ZAINURIE@GMAIL.COM

Single

Yang Zi Jin

South RMB 50/Person/Day

Campus

North RMB 45/ Person/Day

Either

Double

Room

South RMB 25/Person/Day

Type&

North RMB22.5/ Person/Day

Room

Either

Rate

1. 300
Note: Students need to pay RMB300 (cash) as deposit at checking in. The deposit will be returned to the

students at checking out if all the equipment and furniture in the room are in good condition.
2. 150 Dormitory Fee (at least for 150 days in advance)
3. (Room rate during vacation : If student stay in the dormitory during the vocation, 5% of total
will be charged extra as vacation service fee.)
4. The room arrangement depends on the room source
and the order of application.
5. The reserved room is automatically
cancelled if student fails to register on the designated dates without permission.

2 2 1 1 1 1
450/
Bedding is available at the reception (450 Yuan per set), which includes 2 quilts, 2 quilt covers, 1 sheet, 1 mattress, 1 pillow and 1
pillowcase.

Do you want to buy the university bedding?

Yes

No

,
Note: Please consult Admission Office or Program Coordinator if you have questions .the Overseas students Housing reserves the right
to assign rooms and adjust rate.


I hereby affirm that:
(1).(2).
(1) All information above is out of my free will and correct;
(2) I shall abide by the Chinese laws and the university regulations.

: ____________

Applicants signature--------------------------

Date:

year month day

Office Only

Category of Student

Room Assigned