STUDENT VILLAGE CHECK-IN & DECLARATION FORM

Accommodation
STUDENT VILLAGE CHECK-IN & DECLARATION FORM

A warm welcome to your room and we hope that your experience with us has been satisfactory. Please help us to complete this form which is expected to take 5minutes of your time. You’ll need to submit us the form within 3 days after your check in date so that we know that everything in your room is in order.
CHECK-IN DETAILS
Student ID
Check In Date*

DayMonthYear
Date
Building *
Room Type*
Room Number*
Applicable for Twin Sharing*

A (Left side of the room)B (Right side of the room)
AMENITIES CHECK-LIST

PLEASE MARK THE ITEMS CONDITION DURING CHECK IN.
Divan Bed*

Available and in good conditionAvailable but need fixingNot available
Wardrobe*

Available and in good conditionAvailable but need fixingNot available
Bed side cabinet*

Available and in good conditionAvailable but need fixingNot available
Study Table and Chair*

Available and in good conditionAvailable but need fixingNot available
Blind/ Curtain*

Available and in good conditionAvailable but need fixingNot available
Wall Cabinet*

Available and in good conditionAvailable but need fixingNot available
Door Access Card*

Available and in good conditionAvailable but need fixingNot available
Ceiling Fan*

Available and in good conditionAvailable but need fixingNot available
Room Lighting*

Available and in good conditionAvailable but need fixingNot available
Table lamp and Cloth Hanger*

Available and in good conditionAvailable but need fixingNot available
Air-Conditioner*

Available and in good conditionAvailable but need fixingNot available
Mattress Proctector*

Please use the mattress protector that has been provided to you. The mattress protector will keep your mattress clean for you and future residents. Any charges for cleaning of the mattress will be borne by the resident. So please take good care of it like its your own.
GENERAL PRIVACY STATEMENT
The information collected in this form is to process your Check-In & Declaration application. The information is processed in accordance with the Personal Data Protection Act {PDPA) 2010. It is only disclosed to third parties with your consent or to meet statutory obligations. For more information, please refer to the University's Privacy Collection Notice at. https://www.swinburne.edu.my/privacy/privacy-collection-notice

STUDENT’S AGREEMENT & ACKNOWLEDGEMENT (Please use Fill & Sign)

1. I have checked the conditions of amenities provided to me in the Student Village and I do hereby agree to pay for any damages or loss to the items listed above due to my negligence.

2. I confirmed that all the information provided above is correct and I acknowledge having read, understood, and voluntarily agree to all the terms and conditions contained in this form and Swinburne Sarawak Student Village Residents Handbook (Guide and Rules of Occupancy) including any other documents, attachments, or other materials referred to it.

3. I undertake to abide by the Swinburne Sarawak Student Village Resident Handbook (Guide and Rules of Occupancy)
Full Name.*
IC No/Passport No*
Student Webmail*
Students are required to use Student Webmail address
Date.*

DayMonthYear
Date
Should be Empty:

Accommodation

STUDENT VILLAGE CHECK-IN & DECLARATION FORM

CHECK-IN DETAILS

AMENITIES CHECK-LIST

GENERAL PRIVACY STATEMENT