RESIDENTIAL HALL APPLICATION FORM (ON CAMPUS ACCOMMODATION) FOR OFFICE USE ONLY RH Block D E L1 L2 Assigned Room No.

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RESIDENTIAL HALL APPLICATION FORM (ON CAMPUS ACCOMMODATION) FORM/SAA-ASSD-03/01 - Updated: 12-06-2017 Rev 01 Notes: 1. Tenancy dates are subject to the Academic Calendar. 2. Rental fee inclusive of 6% GST for laundry service only. FOR OFFICE USE ONLY RH Block D E L1 L2 Assigned Room No. Student Details Name Student ID No. IC / Passport No. Gender Male Female Contact No. Nationality / Country Malaysian Other : E-mail Address Religion Islam Hinduism Buddhism Christianity Other : Permanent Home Address Home Tel No Intake Date Expected Check-in Date Programme Enrolled English Enrichment Programme Required? Yes : Level No Month Year Emergency Contact Details Name Relationship E-mail Contact No: (H/P) Address (Office) Page 1 of 5

Residential Hall Details Block D Twin Sharing Room Block E Single Room in Apartment Block E Single Room Block E Twin Sharing Room D E Type Type B1 Type C1 Type D1 Type A2 Type B2 (with laundry service & common bathroom) (self-laundry & en-suite bathroom) (self-laundry & en-suite bathroom, limited units) (self-laundry & en-suite bathroom) Block L1 Twin Sharing Room L (with laundry service & common bathroom) Block L2 Single / Super Deluxe Room LA (with laundry service & en-suite bathroom, for 1 / 2 pax, limited units) Block L2 Twin Sharing Room LB (with laundry service & en-suite bathroom) Block L2 Deluxe Room LC (with laundry service & en-suite bathroom, for 1 pax, limited units) Block L2 Double Room LD (with laundry service & en-suite bathroom, for 2 pax, limited unit) PROGRAMME General Intake Medicine Pharmacy Nursing A-Levels Optometry Architecture (Degree) English Enrichment Programme Remarks SEMESTER TENANCY PERIOD Long Semester May 2017 Semester Sept 2017 Semester Short Semester Sept 2017 Intake Sept 2017 Semester Feb 2017 Semester Aug 2017 Semester. Mar 2017 Semester Apr 2017 Semester 03 Jan 17 27 Apr 17 03 May 17 28 Aug 17 05 Sept 17 26 Dec 17 05 Sept 17 06 Nov 17 30 Jan 17 24 July 17 28 Aug 17 17 Feb 18 06 Feb 17 30 June 17 14 Aug 17 05 Jan 18 03 Jan 17 28 Apr 17 03 July 17 28 Oct 17 03 Jan 17 26 June 17 10 July 17 29 Dec 17 14 Mar 17 17 June 17 17 Apr 17 10 Dec 17 03 Jan 17 05 May 17 10 July 17 10 Nov 17 03 Jan 17 27 May 17 06 July 17 27 Nov 17 2017 Semester 2017 2017 RENTAL PER SEMESTER PER PERSON (RM) : 1,205.40 : 1,500.00 : 1,800.00 : 3,616.20 : 3,013.50 : 3,750.00 : 3,616.20 : 1,808.10 : 2,250.00 : 2,700.00 : 4,821.60 : 3,013.50 : 3,750.00 Rental by monthly basis : 602.70 : 750.00 : 900.00 : 3,200.00 : 9,600.00 : 10,800.00 : 7,500.00 : 8,000.00 : 9,600.00 : 10,800.00 : 4,800.00 : 12,000.00 : 12,800.00 : 14,400.00 : 7,500.00 : 8,000.00 : 1,500.00 : 1,600.00 : 1,800.00 Page 2 of 5

On-Campus Residential Hall Rules and Regulations 1. Each application must be accompanied with a non-refundable booking fee of RM 1,000.00. Payment of booking fee does not guarantee a place in the Residential Hall. 2. All bookings are entertained on a first-come-first-served basis. In the event the University is unable to provide a room in the Residential Hall, the booking fee shall be refunded in full. (See important notice for International Students below). 3. All Application Forms must reach the Student Affairs & Alumni (SAA) Division of UCSI University at least 4 weeks in advance of a new semester to secure a place (subject to availability). 4. Upon successful check-in to the Residential Hall, the student is required to make the full semester rental payment before/during the check-in date, if the student failed to make the payment before check-in into the Residential Hall / arrival at UCSI University, the management reserve the right to deny the access of the student, even though the booking fee is paid. 5. Once the rental is paid, the booking fee will then be converted to a refundable deposit. Should the student check-in after the commencement of the semester s orientation the student is still required to pay the full semester s rental for his/her accommodation. 6. Room will be reserved for 14 days after the date of payment. The University reserves the right to release the room after the said period. All payment made will not be refunded. 7. The tenancy period may change depending on the academic calendar, student may require to top up the pro-rate charges per day if additional tenancy is required (subject to the availability, refer to Q2, page 4). 8. All students may be allowed to stay at the University Residential Hall for a maximum of 2 consecutive semesters, subject to availability. 9. Tenancy is valid for one semester, depending on the academic programme the student is enrolled in. Students may apply for their refundable deposits at the end of their tenancy. 10. Tenancy is renewable after the first semester and is subject to availability. Priority will be given to new students. 11. Residents are allowed to leave their belongings in their hostel rooms during the semester break for not more than 7days without charge upon the renewal of their contracts. Should the semester break exceed more than 7 days, residents who wish to leave their belongings and secure the room will need to pay accordingly to the rate. 12. If a resident decides to withdraw before the end of the semester (e.g in the middle of the semester), only the remaining rental will be refunded. The deposit of RM 1,000.00 will be forfeited. 13. Students expelled from the Residential Hall for violation of Residential Hall Rules and Regulations shall not be entitled to the remainder of their rental paid in advance nor their deposit. 14. Deposit will be refunded should a student decides not to renew his/her tenancy after his/her stay at the University s Residential Hall, provided that the facilities and amenities of the relevant Residential Hall unit have been kept in an acceptable condition. SAA shall be the sole discretionary body to decide what may be considered acceptable. 15. In the event that damages have been done upon the property of the University, the student s deposit will be used to cover the cost of returning the said property to its near original state. 16. For any additional stay, the charges are based on the published rate. No family members, relatives or friends are allowed to stay overnight at the Residential Hall. 17. Residents are solely responsible for the safety of their own valuables. All residents are strongly advised to lock all their valuables at all times. 18. The University shall not under any circumstances be responsible for any damage, loss or theft of any property, money and other items belonging to the residents and/or their visitors and any personal injuries suffered by the residents or their visitors/guests howsoever caused. 19. Students are separated by gender to specific floors in the Residential Hall and the assignment of the Residential Hall rooms are at the discretion of the SAA. 20. The air-conditioner operates from 11:00am to 05:00am, for Residential Hall Block D and L1 only. 21. Students are strictly prohibited from bringing in strangers or a person of the opposite sex into their respective rooms. They are also not allowed to behave in such a manner that may embarrass or cause inconvenience to others in the Residential Hall. Friends / fellow students are allowed into the visitors hall only. 22. No visitors are allowed within the Residential Hall. 23. For the twin-sharing room, international students will be paired with either a local or a student from same/another country. 24. Laundry service is provided in the Residential Hall for the convenience of the students. Students are not allowed to wash their own clothes in the shower rooms or to hang wet clothes in the washroom / in their bedrooms / wardrobes. 25. Smoking / vaping, alcohol consumption, gambling and any illegal activity are not allowed in the Residential Hall. 26. The Residential Hall is designated as a Halal area. Non-halal food / items are prohibited. Such items found will be confiscated and disposed by the staff with no compensation to the student(s) involved. 27. Curfew period for the Residential Hall is set at 12 midnight until 7am. 28. Students must provide their own bedsheet and use the bedsheet for the mattress at all time (bedsheet is not provided by the University). 29. Students must keep their rooms and common area clean at all times. 30. Students are not allowed to change rooms and duplicate keys without the prior approval from the Student Affairs & Alumni. 31. In the event of investigation cases, the Accommodation Officer / Warden / Security Guard shall be authorised to search & make inspection of all rooms, which shall not be limited to general search of common areas, but also specific areas, which are underlock and key (e.g. wardrobe). This may be conducted with / without the presence of the student. 32. The Accommodation Officer / Warden / Security Guard may conduct inspections of the premises to ensure all rules are observed at all times. Students must allow maintenance personnel to enter their rooms for maintenance purposes. 33. The SAA reserves the right to terminate the tenancy of those who violate any of the Rules & Regulations of the Residential Hall. 34. All rental paid shall be forfeited, and the University also reserves the right to deduct any amount owing by the student against their deposit, caution fees and other fees or impose any additional charges. 35. The University reserves the right to amend the Residential Hall Rules and Regulations without prior notification. Page 3 of 5

Important Notice for International Students 1. Payment of Booking Fee via telegraphic transfer payment is subject and effective only upon clearance by bank (Depending on the country, this may take 2-3 weeks). 2. All international students are encouraged to stay on-campus for their first semester at UCSI University. In the event on-campus residence is not available, UCSI University off-campus residence will be automatically provided. I,, have read the above *Residential Hall Rules and Regulations and agree to abide by all the stipulated rules and regulations of the University s Residential Hall. Signature: Date: * This is not a comprehensive listing of all the Rules and Regulations for the Residential Hall. Please be sure to familiarise yourself with the full set of Rules and Regulations of the Residential Hall. The University reserves the right to impose new rules and/or amend existing rules in connection with the Residential Hall from time to time, and such additions and amendments shall be duly notified to Students accordingly. (For most current Residential Hall Rules & Regulations, please visit http://www.ucsiuniversity.edu.my/student-support/accommodation/accommodation-kl.aspx) ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- What Do You Need To Know? Q1: When can I check-in? : You are allowed to check-in on the start date of the tenancy period or one day (exclusive of public holiday) before the commencement of the semester s orientation. General Intake Jan 2017 Intake 03 Jan 17 27 Apr 17 Your check-in date is 02 Jan 2017 Q2: What is the pro-rate of different types of hostel room? A2: The table shows different pro-rate based on the types of hostel room. This is not applicable for temporary stay and late check-out without acknowledgement. Residential Hall Single Room Twin / Triple Double Deluxe Sharing Block D - - D RM 25 - - - - Block L1 - - L RM 25 - - - - Block L2 LA RM 70 LB RM 35 LC RM 80 LD RM 45 Block E, Type A RM 90 A2 RM 45 - - - - Block E, Type B B1 RM 80 B2 RM 35 - - - - Block E, Type C C1 RM 70 - - - - - - Block E, Type D D1 RM 45 - - - - - - Block E Apartment E RM 60 - - - - - - Q3: If I check-in before the tenancy start date, how much will I have to pay? A3: There will be no charge if you check in one day before the start of tenancy (e.g. 02 Jan 2017). However, there will be charge if you check-in earlier than 02 Jan 2017. Different charges will be imposed according to types of rooms. For example: Your extra charges = 30 Dec, 31 Dec & 01 Jan 2017 (3 days) Rental Rate with Laundry Total Payment Pro-Rate Service (Pro-rate + Rental Rate) Block D: 3 days x RM25 = RM 75 RM 2,410.80 RM 2,485.80 Q4: If I check-in after the tenancy start date, how much will I have to pay? A4: You will be charged as per semester tenancy period or pro-rate from the check-in date until last date of the semester, as refer to the semester tenancy period. This is applicable to all programmes except English Enrichment Programme. For example: Engineering student check in on 05 Feb 2017 (tenancy period: 03 Jan 17 27 Apr 2017) Residential Hall Room Type Category Total Payment By tenancy period RM 2,410.80 Block D / Block L1 Twin Sharing By pro-rate 82 days x RM25 RM 2,050.00 Page 4 of 5

Q5: If I check-out later than the tenancy end date, how much will I have to pay? A5: If you check out later than the tenancy end date (provided you decided not to renew for the next semester), you will have to pay extra daily charges (with acknowledgement) or overstay charges (without acknowledgement). For example: Based on the table appended above, your check-out date is 27 Apr 2017, by 6pm. If you check-out later than the tenancy, for instance 30 Apr 2017, the charges are as follows: Your extra days is = 28, 29 and 30 Apr 2017 (3 days) Residential Hall With acknowledgement and Without acknowledgement and With acknowledgement to support from the faculty support from the faculty the accommodation officer members members Block D / Block L1 3 days x RM 25 = RM 75 3 days x RM 60 = RM 180 3 days x RM 70 = RM 210 Block L2 / Block E 3 days x Pro-Rate (According to room types) 3 days x RM 108 = RM 324 3 days x RM126 = RM 378 Q6: What are provided in my room? A6: All rooms are equipped with: A wardrobe, a study desk and chair, a bed and a mattress. For hygiene purposes, students are to prepare own pillow, bed sheet, pillow cover and blanket. Q7: What other services are included in my rental fee? A7: The rental rate includes: Water and electricity Wireless internet access Laundry service (Only for Block D, L1 and L2) 24-hour security Q8: When is the check-in time? A8: Your check-in times are as follows: Monday to Friday: 9.00am to 6.00pm; Saturday: 9.00am to 1.00pm (except on Public Holidays) For other times (Sunday, Public Holidays or any time outside the range given above): students will have to make a request to checkin one (1) week in advance. Q9: What if I did not make a rental booking; will I be able to stay temporarily in the residential hall? A9: Yes, you can. However, you need to decide within 2 working days whether you wish to continue your stay in the hostel. If you continue your stay, full accommodation fees and RM 1,000 (rental deposit) will be charged. Students will be charged an additional RM 50 administrative fee for the conversion. If you do not continue to stay, the daily charges will be charged based on your stay earlier RM 60 or RM 108 per day. This application is complete only if the applicant acknowledges having read and understood the Residential Hall Rules & Regulations on page 2. The information contained herein is correct at the time of printing and the University reserves the right to make changes, alterations and amendments without prior notice. FOR OFFICE USE ONLY PAYMENT DETAILS CHECK-IN DETAILS Booking Fee Paid RM1,000 EHMS Customer ID Rental Charge Check-In Date Rental Paid EHMS Check-In Done TRANSFER DETAILS Room Transferred CHECK-OUT DETAILS Check-Out Date Date Transferred EHMS Check-Out Done EHMS Transfer Done Remarks UCSI Education Sdn. Bhd. (185479-U) No. 1, Jalan Menara Gading, UCSI Heights, Cheras, 56000 Kuala Lumpur, Malaysia Tel: 603-91018880 / Fax: 603-91023606/ Email: rhall@ucsiuniversity.edu.my Page 5 of 5