Application

Personal Details

Surname *

First name *

Date of Birth *

Email Address *

Gender * MaleFemale

Address for contacting prior to arrival

Street *

City/Town *

Postcode *

State *

Country *

Telephone *

Fax

Name of Parent or Guardian *

Phone Contact for family/Guardian in case of emergency

Street *

City/Town *

Postcode *

State *

Country *

Telephone *

Fax

Current or Proposed Enrolment details

Tertiary Institute

Course

Accommodation

Preferred Property 8-10 Edward Road - $200 per week79 Ellis St - $200 per week67a Ellis St - $200 per week

NOTE : Price includes gas, electricity, water & ADSL Internet .

Residency Time Frame

It is a requirement that all students occupy the rooms for the full academic year of 41 Weeks.

Start Occupancy *

End Occupancy *

Schedule of Payment * MonthlyQuarterlyHalf YearlyYearly

There is no guarantee that a room is available unless a non refundable deposit of $330 is made and confirmation of room availability is given by management.

This will be offset against your rent.

Four weeks rent is required four weeks prior to occupancy. Please fill in all sections and submit by fax, email or mail.

If you have any further questions please contact us.

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