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CUCMS-FAC-FRM001;Rev 01

FACILITY DEPARTMENT

FILL IN 2 COPIES
VENUE BOOKING FORM
(This form should be handed to us 3 days before is required)
DETAILS OF BORROWER Date :
Category of Borrower Staff / Student / Other
Name Hamzah Asadullah B Ahmad IC / ID No 020126-06-0729
Department /Faculty / Society Faculty of occupational safety
and health
Address / Email Address qasadullah02@gmail.com

Contact No 011-2199-4727
Venue R406
Date From:25th May 2022 To:26th Duration: 2 days
May
2022
Time From: To: Duration: hours
DESCRIPTION OF VENUE (FACILITY)
Date Checked
No Venue Equipment Required Purpose
out in
1 R406 2 Projectors and 2 Movie night 25th May 26th May
sounds 2022 2022

( Please Fill Up with full details (event,layout,etc) or attach with supporting documents (if any) APPROVED
BY :
Dean/Lecturer/Registrar /SAD Facility Unit WORK ORDER
Facility Staff In-Charge
1)
Approve Reject
AvailableNot 2)
3)
ApproveReject

(Date,Signature & Stamp)


(Date,Signature & Stamp)
Comments :

I have read the term and conditions,and agree to abide by above terms and conditions
STATUS INFORMED : VENUE SET UP DETAILS :
Call to : Chair Projector
Call by :
Time : Table Others
Date :
Sound
Signature :
University Of Cyberjaya,Persiaran Bestari, Cyber 11,63000 Cyberjaya, Selangor
Tel :03-8313 7074 Fax No : 03-8313 7090

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