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Surname:
Given Names:
Date of Birth:
Nationality:
Gender:
Male
Female
Email address:
Contact Telephone Number:
Approximate date of arrival
Length of lease required
Are you a smoker?
No
Yes
Your Home Address
Street Name and Number:
City:
State/Province:
Country:
Post Code/Zip:
Your Current Address
(if other than above)
Street Name and Number:
City:
State:
Post Code/Zip:
Length of Occupancy:
Name of Agent/Owner:
Phone Number for agent/owner:
Which College/University will you attend?
Student Card Number:
Personal Reference
(not a relative)
Name:
Contact Phone Number:
Relationship:
By submitting you confirm that you have read, understand and accept that:
This form is an Application Form only
You have read and understood and accept the
House Rules
You have read and understood the
Frequently Asked Questions
You are willing to enter into a
standard Tennancy Agreement
form prior to taking up residence.