Dormitory Exit Clearance Form
Full Name
Student ID
Dormitory Name/No.
Room Number
Contact Number
Date of Leaving
Reason for Exit
Room Condition Checklist
Item
Good
Damaged
Remarks
Bed
Desk & Chair
Wardrobe
Fan/AC
Lighting
Other
Remarks (if any)
Student Signature & Date
Dormitory In-charge Signature & Date