Guest Pass Policy And Procedure (Page 2 of 2) in pdf

Guest Pass Policy And Procedure Page 2

Office approval:

Real Estate Development + Facilities

Housing Services One Park Avenue, 10

floor

______________________________________________

Please read the Guest Pass policy and procedure before submitting this request.

GUEST PASS

_________________________________

(

)_________________

________________________________

(

)___________________

Host’s (“Host”) Name print

Host’s cell phone #

Guest’s (“Guest”) Name print

Guest’s cell phone #

Vilcek Hall #__________

Greenberg Hall #__________

Lipton Hall #__________

334 E. 25

St #__________

Guest Arrival Date: _________________

Departure Date: _________________ (not to exceed seven days)

mm/dd/yy

The Host affirms the informed permission of roommates and that they support this Guest Pass request.

______________________________

_________________________________

_______________________________

Roommate Name 1

Roommate Name 2

Roommate Name 3

In accordance with New York City law, NYULMC Security and NYULMC housing policies, Host understands and agrees that this

Guest Pass may not be used to facilitate or provide any form of transient housing. The NYULMC Host and Guest agree and certify

that no payment, goods or services have been or will be provided in return for this accommodation.

Guest Passes do not authorize independent access to other medical center buildings or to medical center facilities requiring a card swipe.

Guests are not provided with card swipe, lockout, or key replacement services.

Host agrees to assume responsibility for Guest’s actions during the visit. The Guest will present photo i.d. and the approved Guest Pass for

access to the NYULMC building and apartment in which the Host resides. NYULMC Security and Housing Services reserve the right to

revise or revoke Guest Passes or building access at any time. Host certifies that the Guest has been informed of Guest Pass and other

NYULMC policies.

Host’s Signature and date:

______________________________

Guest Pass Policy And Procedure Page 2