STUDENT ACCOMODATION AGREEMENT 2015/17 QUESTIONNAIRE TERMS & CONDITIONS of the Student Halls of Residence Poznan University of Life Sciences Surname Name ID/Passport No. Nationality Sex Course Phone number Stay from: 1st October 2015 to: 28th February 2017 I hereby decide to be accommodated in the Dormitory chosen below (tick the right option): Dormitory type* Rent per month Rent per Rent for the full course Tick semester period** Double room 95 EUR I semester 475 1615 EUR - 95 EUR discount EUR II semester 380 (after discount: 1520 EUR) EUR + 285 EUR (summer break) III semester 475 EUR Single room 120 EUR I semester 600 2040 EUR – 120 EUR EUR discount II semester 480 EUR + 360 EURO (after discount: 1920 EUR) (summer break) III semester 600 EUR Studio 350 EUR I semester 1750 5950 EUR – 350 EUR EUR discount II semester 1400 EUR + 1050 EUR (after discount: 5600 EUR) (summer break) III semester 1750 EUR *Detailed descriptions of each room type are available upon request ** If a student does not wish to stay in the Dormitory over the summer break (July – September) the three months rent will be deducted from the above prices individually upon students enquiry I hereby declare to pay Dormitory Fees by bank transfer, based on the provided pro-forma invoice (tick the chosen option): o In full before the starting date of the course Friday 26 September 2015 o Per semester: in 3 instalments, payment due dates are as follows: Friday 26 September 2015 Friday 27 February 2016 Wednesday 30 September 2016 A student applying for an accommodation is obliged to submit: 1. Filled and signed Questionnaire 2. A valid ID/Passport 3. A passport photo to be used for issuing the Resident Card Student who wishes to be accommodated in the Student Halls of Residence agrees to: Pay required fees in time, according to the dates and amounts chosen above. Your accommodation will be provided by the student halls administration, therefore Poznan University of Life Sciences reserves the right to refuse a place in the student accommodation if the student does not pay required fees in time. Failure to pay or to keep to the terms and conditions of this agreement could result in 14 days’ notice to quit the accommodation. In the case of serious misconduct this may involve exclusion from accommodation prior to formal disciplinary action. The resident is obliged to: 1. Arrive to and leave the accommodation accordingly to the dates provided by the house administration. 2. Make an inquiry to the house administration if you wish to change your room. Changes to rooms may only be made if there is an alternative option available at the time of the inquiry. 3. Care for the property of the student house. 4. Keep the room and bathroom tidy and clean ( wash the floor, cabinets, washbasin, shower, toilet, systematically empty trash bins). Keep common areas clean (kitchen, laundry, hallways). Failure to keep to the above maintenance rules will result in the call for professional services to clean the rooms and common areas after the previous notice. The costs of cleaning and maintenance will be charged to responsible students. 5. Present your Resident Card when entering the student house and collecting the key. 6. Leave your room key at the reception every time you leave the student house. 7. Lock the door when you leave the room and/or go to sleep. 8. Do not disturb your neighbours/roommates at night and behave quietly from 11pm to 6am. 9. You are not allowed to smoke or use drugs in the student house. 10. Treat the house administration members and other residents with a respect, kindness and tolerance accordingly to their beliefs and culture. Violation of this rule may result in 14 days’ notice to quit the accommodation. Internet: You should come to the house administration and take a username and password. Internet charge is included in your rent. Find us on Facebook: https://www.facebook.com/DSUPPN Website: www.up.poznan.pl/akademiki Before moving out residents are obliged to: 1. Notify the administration or the reception about the date of your departure. 2. Clean the room, interior hallway and bathroom. 3. Collect signatures on the Student House Administration Check List provided (karta obiegowa DS). 4. Return your Resident Card, Check List and your room key to the student house administration. Signature of the student: DATE: …………………………… Signature:……………………………………………………… Signed by the Universities’ authorized person: DATE: ………………………...... Signature:……………………………………………………….