RES003 RESOURCES & OPERATION DEPARTMENT

Facilities Requisitions
(Application for use of room / equipment / space)

Campus Cambodia

Applicant Name Ork Kimhab Date

ID Number Class
806 (student only)

Contact (Ext/Mobile) 070 91 70 81 Staff Student Others

Section A: Requisition Information
Date of Application Date of Usage
Place of Usage 710 Time of Usage

Type Required: Description:

Equipment 1. __________________________ 4. ___________________________
Room / Space 2. __________________________ 5. ___________________________
Manpower 3. __________________________ 6. ___________________________
Others: ____________________

Purpose:
Make Up class

Application Verification
by Applicant

Signature of Applicant Name of Applicant Date

Application Verification
by HOS/PL/Lecturer

Signature of HOS/PL/Lecturer Name of HOS/PL/Lecturer Date

For Office Use Only • FOR APPROVAL

Comments & Decision of Resource

Approved Not Approved Others _________________________
Committee
Remarks

Terms and Conditions

1. Application form must be submitted to Resource for approval duly signed by the lecturer
2. All facilities are on first come first basis and subject to availability only.
3. Persons borrowing the items / equipment will be responsible for any loss or damage to the equipment / place
4. Equipment on loan must be handled with care. If unclear of usage to refer to Resource counter staff.
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Last edited: Aug 2009