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Facilities Request Form
Facilities Request Form
APPLICATION DATE
_________________________________
Form must be completed & returned 14
days prior to activity date requested!
EVENT INFORMATION
EVENT:
EVENT PURPOSE:
NUMBER EXPECTED:
VENUE: 1. 2. 3.
AGREEMENT
In making this request for facilities, the user agrees to abide by rules and regulations of SEGi University. By
signing below, the user agrees to be responsible for all activities, security and actions of members of their
group. SHOULD DAMAGE OCCUR OR EQUIPMENTS BE UNRETURNED, A FEE WILL BE ASSESSED TO THE USER
ACCORDINGLY. All facilities being used must be returned to their original condition after use, including
cleanliness and re-organization of tables/ chairs, if necessary.
As the user of facilities, I have read and understand all portions of the events form and agree to the terms and
conditions set forth by this contract
FACILITIES CHECKLIST
sofa
TABLE
banquet
exam
coffee table
MIC ( PA system)
wired
cordless
mic stand
rostrum
Red Carpet
CAR PARK
MPH
Indoor
VIP
SIGNAGE
IT
Projector
Laptop
Cable
……………………………………. …………………………………………
Chairperson Advisor
Name: Name:
Date: Date:
NOTE: Please complete the form in full and attach the necessary information for reference before submitting to RESOURCE PLANNING
UNIT.
Attachment Checklist:
Completed form
………………………………….
Admin, Resource Planning Unit:
Date:
……………………………………
Head of Department, Resource Planning Unit:
Date:
Approved by,
REMARKS
……………………………………
Manager, Facilities Management:
Date:
Approved by,
REMARKS
……………………………………
Manager, Building Management:
Date:
REMARKS
……………………………………..
Deputy Vice Chancellor (Student Affairs)
Name: Prof. Azrin Ariffin
Date: