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MMU/SD/form/04 SECURITY DIVISION MMU VEHICLE STICKER SESSION 2009/2010 Please tick X one of the boxes Price list for vehicle sticker Academic Non-Academic Student Vendor Staff Car Motorcycle RM 6. 00 RM 2. 00 APPLICANT S BACKGROUND Name ID / IC Number Office Telephone Number Driving License HP / Mobile Number License Expiry Date PARTICULARS OF VEHICLE Vehicle Type Vehicle Model / Color Vehicle Registration No Vehicle Grant No Note Kindly enclosed a photocopy of your ID or IC and Valid Driving Licence. DECLARATION I agree to comply with all the Road Transport Act 1987 and any regulations enforced by the Multimedia University from time to time. I understand that if I commit a breach of or fail to comply with or contravene any of these regulations or any terms and conditions imposed under the regulations I will be held liable for a traffic offence. I also understand that the University is not responsible for any loss or damage to any vehicle parked in the campus area* Parking is at one s own risk. I hereby declare that all the information given is true and correct. Date Applicant s Signature FOR OFFICE USE Car / Motorcycle sticker number Sticker collected by Date collected For Director of Security MMU. 00 RM 2. 00 APPLICANT S BACKGROUND Name ID / IC Number Office Telephone Number Driving License HP / Mobile Number License Expiry Date PARTICULARS OF VEHICLE Vehicle Type Vehicle Model / Color Vehicle Registration No Vehicle Grant No Note Kindly enclosed a photocopy of your ID or IC and Valid Driving Licence. DECLARATION I agree to comply with all the Road Transport Act 1987 and any regulations enforced by the Multimedia University from time to time. DECLARATION I agree to comply with all the Road Transport Act 1987 and any regulations enforced by the Multimedia University from time to time. I understand that if I commit a breach of or fail to comply with or contravene any of these regulations or any terms and conditions imposed under the regulations I will be held liable for a traffic offence. I understand that if I commit a breach of or fail to comply with or contravene any of these regulations or any terms and conditions imposed under the regulations I will be held liable for a traffic offence. I also understand that the University is not responsible for any loss or damage to any vehicle parked in the campus area* Parking is at one s own risk. I also understand that the University is not responsible for any loss or damage to any vehicle parked in the campus area* Parking is at one s own risk. I hereby declare that all the information given is true and correct. Date Applicant s Signature FOR OFFICE USE Car / Motorcycle sticker number Sticker collected by Date collected For Director of Security MMU. 00 RM 2. 00 APPLICANT S BACKGROUND Name ID / IC Number Office Telephone Number Driving License HP / Mobile Number License Expiry Date PARTICULARS OF VEHICLE Vehicle Type Vehicle Model / Color Vehicle Registration No Vehicle Grant No Note Kindly enclosed a photocopy of your ID or IC and Valid Driving Licence. DECLARATION I agree to comply with all the Road Transport Act 1987 and any regulations enforced by the Multimedia University from time to time. I understand that if I commit a breach of or fail to comply with or contravene any of these regulations or any terms and conditions imposed under the regulations I will be held liable for a traffic offence.

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