OSH Form #2 UNIVERSITY OF THE PHILIPPINES DILIMAN Revised: 06.28.13, Ditiman, Quezon City (With revisions for 44/4 ¢- Residence Hall: July 2017) RESIDENCE HALL AGREEMENT eae having Deen duly sworn, hereby Gedlare tat 1 | understand that accommodation in @ U.P. residence hall Isa privilege granted to @ University student on the basis of his her voluntary desire to avail of such privilege. | am fully aware of the conditions and limitations of Molave Residence Hall, and the rules cconceming its facies, water supply, malntenance, peace end order, and the like, as ‘contained on the printed information posted on the bulletin board. During my stay in. Room No. Of this Residence Hall for the duration of Academic Year 2017-2018 (2 ‘semesters inclusive of the Midyear Term), | bind myself to comply with the House Rules of ‘Molave Residence Hall, including all memoranda, circulars and orders. emanating from the Residence Hall Management, the 2008 Rules and Regulations Governing Residence Halls {in UP Diliman (as amended), and its Implementing Guidelines, all issuances of the duly Consttuted authorities ofthe U-P., and all applicable laws and local ordinances. | shall pay my residence hall fees in ful al the start of the semesterimidyesr term, orf paying ‘monthly, | shall pay my monthly fee, as assessed by the Residence Hal Management, every 7° day of the month, to the University Cashier for the duration of the above-stated academic Year, without the necessity of demand. Otherwise, | shall pay @ surcharge of one percent (1%) per month, reckoned from the date due, unt fully paid. ‘Should | fll to pay said monthly fee for two (2) consecutive months, | may be evicted from the Residence Hall in accordance with paragraph 7 below, within three (3) days from written notice served to me personally, oF Posted on the bulletin board by the Residence Hall Management. On the other hand, should | ecide to leave Ayz/ee-e- Residence Hall et any time before the expiration of the aforesaid ‘academic year, 1 out ofthe dormitory befor Gan for non academic = elated ectves? VES, Place pedly the tie — [ARE THERE DESIGNATED GUARDIANS FOR YOUR DAUGHTER DURING HER STAV HERE IN METRO MANILA? YE\___NO___IfVES, please request them to sgn below. Designated guardians should net be more than two. LANDLINE 1 WORILE. NUMBER [EWAIL ADDRESS ;GNATURE ‘Any adelional tration: or information which you deers necenary for better auidance of your son may be enumerted Lunde "Remarks" Pease fee fee to confer uth x ore are uno uth you coneming er waka [REMARKS (Use back page H needed) IMPORTANT: Please discuss above matters with your daughter before soning. PARENTS STGNATORE OVER PRINTED NAME HONE ADDRESS TEL, NOS. WOBILE NOTE WALL ADDRESS ‘OFFICE ADDRESS TEL NO TEMA ADDRESS Wav) Date Aecomplied