NATIONAL UNIVERSITY OF SINGAPORE

FASS

76-12 Faculty of Arts and Social Sciences,

ean!s Office

(To be completed in duplicate) APPLICATION FOR USE OF ROOMS BY FASS STUDENTS

To

" Officer in#c$ar%e ean!s Office, FASS Personal Part !"lars Na&e of Or%anisation"

Se&inar Roo&
(Please tic) accordin%ly*

Lecture T$eatre

'enc$

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ +++ A,,licant!s esi%nation in Or%anisation" ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Na&e of A,,licant" +++++++++++++++++++++++++++++++++++++++++++++++++++++++ E&ail"

+++++++++++++++++++++++++++++++++++++ -ourse . Year of Study" +++++++++++++++++++++++++++++++++++++++++++++++++++++++ /atric No" +++++++++++++++++++++++++++++++++++++ Address" ++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 01P -ontact No"

++++++++++++++++++++++++++++++++ 22222222222222222222222222222222222222222222222222222222222222222222222222222222222 Na&e of S,onsor (if not Or%anisation itself*" # ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ E#ent Deta ls Title of E3ent" +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++ Venue Re4uest 6* ++++++++++++++++++++++++ ate 1 ay Ti&e 1 Period No5 of Persons Attendin%

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++++++++++++++++++++++++++++++++ 7* ++++++++++++++++++++++++ ++++++++++++++++++++++ ++++++++++++++++++++++

++++++++++++++++++++++++++++++++ Pur,ose of E3ent" +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++ 2222222222222222222222222222222222222222222222222222222222222222222222222222222222 For Tal$s % For"&s % D s!"ss ons ' ( a))l !a*le+ (a* Na&e of S,ea)er(s* +++++++++++++++++++++++++++++++++++ Or%anisation 1 Institution esi%nation 1 Position

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(8* To,ic" +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++ 222222222222222222222222222222222222222222222222222222222222222222222222222222222 Per& ts ' ( a))l !a*le+ If you $a3e non#&e&8ers attendin% t$e function in any ca,acity, a ,er&it fro& t$e /inistry of 0o&e Affairs (Pu8lic Entertain&ent Licensin% Unit* is re4uired5 PER/IT NO" +++++++++++++++++++++++++++ If s$o9in% fil&, ,lease state" (a* Title" ++++++++++++++++++++++++++++++++++++++++++++++++++ Len%t$ of Fil& +++++++++++ 0r(s* ++++++++++ /ins (8* Pu8lic Entertain&ent Per&it No" ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ eclaration (please tick accordingly) I $a3e sou%$t t$e a,,ro3al of &y acade&ic ad3isor for t$e e3ent(s* a8o3e On 8e$alf of &y or%anisation, I a%ree to a8ide 8y t$e conditions listed %o3ernin% t$e use of t$e ,re&ises of Faculty of Arts and Social Sciences and ,ay fees sti,ulated 8y t$e ean!s Office5 Si%nature . NA/E of A,,licant" +++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++ ,Atta!- '1+ a))ro#al e&a l (ro& a!a.e& ! a.# sor / '2+ a !o&)lete. !-e!$l st (or& alon0 1 t- t- s a))l !at on
Con. t ons For Use o( Fa!"lt2 o( Arts an. So! al S! en!es 'FASS+ Pre& ses 6* 7* :* ;* <* For NUS student or%anisations, 8oo)in% of ,re&ises s$all 8e &ade only after a,,ro3al $as 8een %i3en 8y t$e Office of Students Affairs (OSA*5 'oo)in% of ,re&ises s$all 8e &ade at least : days in ad3ance5 T$ere s$all 8e no 8oo)in% of ,re&ises on Saturdays, Sundays and Pu8lic 0olidays5 T$e Faculty ,re&ises s$all not 8e used for ,ri3ate or ,olitical ,ur,oses5 T$e ,re&ises s$all 8e used only for acti3ities a,,ro3ed 8y ean!s Office, FASS5 T$e Faculty reser3es t$e ri%$t to refuse ,er&ission to use t$e ,re&ises for any function 9it$out assi%nin% reason 9$atsoe3er5 A,,licant 1 Or%aniser &ust ensure t$at" a* T$e ,re&ises are )e,t clean and free of litter after use5 8* No food or refres$&ent is consu&ed in t$e roo&s5 c* Orderliness is &aintained durin% t$e function5 T$ere s$all 8e no ,erfor&ance (e5%5 &usic or dance*, use of sound e4ui,&ent or &usical instru&ents used in t$e facilities5 Any re4uests for e>ce,tions 9ill re4uire ,rior clearance 9it$ ean!s Office staff in#c$ar%e5 No e>ternal sound e4ui,&ent, &usical instru&ents 1 e4ui,&ent, di%ital or ot$er9ise (includin% ,ersonal e4ui,&ent*, is to 8e ,lu%%ed into t$e roo&1LT!s sound syste&5 To &ini&iAe dan%er, all NUS fire re%ulations &ust 8e follo9ed (e5%5 no na)ed fla&es are to 8e used, includin% candles and tea# li%$ts5* If t$e function is closed to t$e ,u8lic, t$e or%aniAer &ust ensure t$at no &e&8er of t$e ,u8lic is ad&itted5

ate"

=* ?* @* B*

6C* T$e Faculty reser3es t$e ri%$t to ins,ect and cancel at any ti&e, a function 9$ic$ in t$e o,inion of t$e Faculty de3iates fro& t$e stated ,ur,oses, or 9$ic$ contra3enes t$e conditions a8o3e5 66* T$e Or%aniser s$all ,ay for all losses, da&a%es and costs of re,lace&ent to facility e4ui,&ent, fi>tures and furniture5 67* Any fee ,aid 9it$ an a,,lication is non#refunda8le unless t$e 9ee) ,rior to t$e due date of a function5 ean!s Office is notified of t$e cancellation 8oo)in% at least one

DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD FOR INTERNAL % DEAN3S OFFICE4 FASS USE ONLY A,,ro3al 8y Office of Student Affairs (YI0*

T5E FUNCTION IS APPRO6ED 0ead, Office of Student Affairs Pay&ent at Student Ser3ice -entre (%round floor, YI0* 7L%8BS n"&*er9 C-1:1-:::-::1-::1%;<=112 Office of Finance -onfir&ation 8y ean!s Office, FASS T5E BOO>IN7 IS CONFIRMED

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++++++++++++++++++++++++++++++++++ f. Officer in#c$ar%e, ean!s Office