AUTHORIZATION FORM For Return of Academic Dress & Collection of Refund

I have authorized the bearer of this form, __________________________________________(name) of CHUA ZHI QUAN, ADRIAN NRIC/Passport #______________________________, to return the Academic Dress and to collect the refund of the deposit on my behalf. I understand that the bearer will only be able to collect the refund of deposit if the Academic Dress is assessed to be in good condition.

For the refund of the deposit, please provide the following details. Graduates Name : Student Number / ID : Rental Receipt Number : Email Address : Contact Number Of Graduate :
HANERYN@GMAIL.COM 9111 6050 WU YA HAN

(in block letters)

A0071156L

Contact Number Of Authorized 9828 9079 Person:

__________________ Graduates Signature Note: Bearer of this form must produce a copy of his/her identity card, a copy of the Graduates Student Card or NRIC or Passport and the Academic Dress Rental Receipt. Deposit will be refunded in cash on the spot provided academic dress no damages. . FOR ENQUIRIES GOWN RETURN PERIOD TIME VENUE MAILING ADDRESS Tel #: 6777 7332; Email: copgown@nus.edu.sg 21st September 2013 to 25th September 2013 Weekdays : 9.30am to 7.00pm Saturday : 9.30am to 3.00pm Sunday & Public Holidays : Closed Ground Floor, Central Library, Kent Ridge Crescent Kent Ridge Post Office, P O Box 1011, Singapore 911101