Personal Particulars 个人资料
Name
姓名		 （E） *（中）
IC/Passport No.
身份证/护照号码		 *
D.O.B
出生日期		 *
Nationality
国籍		 *
Race
种族		 *
Gender
性别		 Male 男 Female女
Religion
宗教		 *
Contact No.
联络号码		 Mobile(手机) *
Email
电邮		 *
Course Enrolled
就读科系		 Intake
入学		 Year 年 Month 月
Correspondence Address
联络地址		 *
Postcode 邮区
Special Medical Condition
特殊健康状况		 No Yes (please state 请注明)
(If yes, please provide medical report for reference in case of emergency)

Parent’s/Guardian’s Particulars 家长/监护人资料
Name
姓名		 （E） *（中）
Relationship
关系		 *
Contact No.
联络号码		 Home（家） * Mobile（手机） *
Correspondence Address
联络地址		 *
Postcode 邮区

Choice of Accommodation 住宿选择
Type of Rooms 房类 Deposit 抵押金
 Rental (By Semester) 住宿费 (学期)
March Intake June Intake October Intake
Twin Sharing Rooms 二人房
(Non air-conditioned)
Mattress, pillow, bed sheet & blanket not included 不提供床褥、床单、枕头、被单等 		RM300 Local Student
RM500 Int. Student 		RM720
(Other courses)		 RM1,080
(Other courses)		 RM1,080
(Other courses)

Twin Sharing Rooms 二人房
(Air-conditioned)
Mattress, pillow, bed sheet & blanket not included 不提供床褥、床单、枕头、被单等 		RM300 Local Student
RM500 Int. Student 		RM960
(Other courses)		 RM1440
(Other courses)		 RM1440
(Other courses)
Trio Sharing Rooms 三人房
IEB Block E (Air-conditioned)
Mattress, pillow, bed sheet & blanket not included 不提供床褥、床单、枕头、被单等		 RM300 Local Student
RM500 Int. Student 		RM1050
(Other courses)		 RM1575
(Other courses)		 RM1575
(Other courses)
Twin Sharing Rooms 二人房
IEB Block E (Air-conditioned)
Mattress, pillow, bed sheet & blanket not included 不提供床褥、床单、枕头、被单等		 RM300 Local Student
RM500 Int. Student 		RM1500
(Other courses)		 RM2250
(Other courses)		 RM2250
(Other courses)

Special Request 特殊要求
Notes：Allocation of room is solely on the SRU discretion. Any special requests must be reviewed by SRU. Decisions will be made by taking the reason of application and applicant’s condition into considerations. Priority will only be given to applicants with disabilities and health issues etc.
备注：房间分配编排以及任何特殊要求须经宿舍组审核批准方为有效。宿舍组将会依据申请者情况（如隐疾、健康状况等）给予酌情处理。
Special Request
特殊要求
Eg: Request 1st Floor Room, request same room with siblings, request other check-in date etc
例：要求底楼房间、要求跟亲人同房、要求其他日期报到等
Reason of Application
申请原因
Order Mattress
订购床褥		 No 无需 Yes, please order 5’’ mattress 需要, 请协助订购5寸床褥
If yes, please pay RM180 to AFO during office hour before the check-in date.
如需订购床褥，在正式入住前，请在办公时间到财务处付费RM180.

Terms and Conditions 规章与条件

  1. All student residents shall observe and comply with the rules and regulations of the student residence as embodied in the Student Manual, Agreement and Rules and Regulations for Student Residence or any other rules and regulation the management may see fit to implement from time to time. 所有宿舍生都需遵守学生宿舍的规章制度包括学生手册、同意书与宿舍规章，又或校方根据情况添加的条例。

  2. All students of Southern University College can apply the student residence. They must fill in the student residence application form and pay a deposit. Students are living in other states will have priority in reviewing the student residence application. The review of the application of students living in Johor will be based on the reasonable allocation and arrangement of vacant.本校所有在籍生均可申请入住宿舍，居住于外 州的本校在籍生将优先审核入住宿舍申请，居住于柔佛州本校在籍生的入住申请审核将视空床位作出合理的分配及安排。

  3. Applicant is required to pay a deposit of RM300 (RM500 for International Students) when submitting the application form. Payment of deposit does not guarantee confirmation of the selected room type. 申请表格必须随同宿舍三百零吉抵押金（国际生抵押金为五百零吉）交于财务 处。抵押金不能用于保证所选房类。

  4. All applicants will be notified as to the success or otherwise of their application within three (3) working days upon the receipt of form by Student Residence Unit (SRU). Upon confirmation of the availability of rooms, applicant is required to pay the rental fees in advance (by semester) prior to check-in.宿舍组将在收到申请的三个工作日内进行批示，唯申请批准后缴付住宿费。住宿费以学期为计算单位，申请者必 须于入宿前缴清一个学期的住宿费。

  5. Resident who fails to pay rental within the stipulated time will be evicted from the Student Residence 拖欠住宿费者，在缴费期限而未缴交宿 舍费，将被勒令退宿。

  6. Allocation of room is solely at the discretion of SRU. Any special requests must be reviewed by SRU. Decisions will be made by taking the reason of application and applicant’s condition into considerations. Priority will only be given to applicants with disabilities and health issues etc.房间分配编排以及任何特殊要求须经宿舍组审核批准方为有效。宿舍组将会依据申请者情况（如残疾、健康等）给予酌情处理。

  7. Extra Charges will be imposed on early check-in 提早申请入宿学生将根据宿舍收费标准缴交住宿费用:
    Without Air-Conditional    学生宿舍[无冷气] （二人房） RM20/每人/日 | RM240/每人/月
    With Air Conditional         学生宿舍[有冷气] （二人房） RM30/每人/日 | RM320/每人/月
    IEB Block E 国际教育感恩大楼宿舍（三人房） RM50/每人/日 | RM350/每人/月
    IEB Block E 国际教育感恩大楼宿舍（二人房） RM75/每人/日 | RM500/每人/月

  8. Maximum tenancy is twelve (12) months. Student residents are required to move out from the student residence at the end of the twelfth (12) month of tenancy or upon graduation to facilitate cleaning and clearance job by the Student Resident Unit (hereafter as ‘the Unit) and AGO. Those who wish to extend their tenancy will have their qualification evaluated by the Unit according to the remaining space, personal traits, and disciplinary records. Such application shall be made within stipulated timeframe, and payment shall be made on time. Anyone who has not made such application before the deadline will be deemed as voluntary disqualification. The Unit reserves the right to refuse any application that does not comply with this regulation without providing any reason.
    入宿满一年者，在学期结束时，期满或应届毕业宿舍生必须迁出宿舍，以方便宿舍组及庶务处清理宿舍。如欲申请续住，本组将视宿舍空 位、个人素质、及纪律记录为审核标准。申请者需在规定时间内提出申请，经审核后必须在指定的时间缴费。逾期未申请者，视作弃权论。 本组有权拒绝不符合本规章之任何申请，而无须提出任何理由。

Student Declaration 学生声明

I have read the Student Residence Rules and Regulations, agree to abide by them 本人已阅读学生宿舍规则并同意遵守这些条例。

By signing the document, I understand and fully agree 通过签署该文件，我了解并完全同意:

  1. I understand and accept the above terms and conditions (Section E) 本人明白与接受以上规章与条件。

  2. I confirm that all information provided in Section A-D is true and accurate, and I understand that submission of any false information will render me ineligible for student accommodation. 本人确认以上所提供的资料乃真实准确；并清楚明白如有任何虚假资料，本人将被取消申请宿舍资格。

  3. I understand to make payment of rental fees in a timely manner if my application is successful. 本人明白申请批准后须按时缴付住宿费。

  4. I undertake to abide by the Rules and Regulations for Student Residence. 本人承诺遵守学生宿舍規章。

  5. Residents are required to take care of your personal belongings, and Campus management will not responsibility for the loss, theft or damage to any personal belongings. 宿舍生需自行管理房内的个人财物，若任何遗失、盗窃、或破坏等需自行承担，校方一概不负责。