Surname:
Given Names:
Date of Birth:
Nationality:
Gender:
Email address:
Contact Telephone Number:
Approximate date of arrival
Length of lease required
Are you a smoker?
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.