Tonsley room booking form

Your details
First name
Last name
College/Section/Organisation
Access number
Student/staff number
Email
Phone number
BIKE DETAILS
Make and model
Colour
DECLARATION
I undertake not to lend my card to or allow access to any other person. I undertake to inform Security immediately if my access card is lost/stolen I will notify Security of any breaches to the bike stores that I notice.

Please note: No responsibility is accepted by Flinders University for any loss or damage.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please provide access to bike store
Authorised
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Your details