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Student Accommodation
Application Form
Please read and accept our
Terms and conditions
before filling the Application Form.
Please fill all your details correctly and clearly. Any unclear information will cause delay for your application.
First Name :
*
Family Name :
*
Gender :
*
Male
Female
Nationalty :
*
Date of Birth :
dd / mm / yyyy
Proposed Arrival Date :
*
dd / mm / yyyy
Proposed Departure Date :
*
dd / mm / yyyy
Accommodation Preferences :
*
Room Facilities :
Private Room
Shared Facilities Room
Room Type :
Single Bed Room
Double Bedroom
Twin Share Room
Share Preference :
Female Only Floor
Mixed
Parent / Guardian Name :
Home Country Address :
Telephone Number :
Fax Number :
Mobile Number :
Email :
*
Emergency Contact Name :
*
Emergency Contact Number :
*
Passport Number :
Expiry Date :
dd / mm / yyyy
Visa Number :
Expiry Date :
dd / mm / yyyy
Drivers Licence Number :
Expiry Date :
dd / mm / yyyy
Name of School :
Signature :
Date :
dd / mm / yyyy
* need to fill compulsory