Cecil Complex Student Accommodation Application Form

Cecil Complex Student Accommodation Application Form

Please fill out the application form carefully
Year of Application
Year of Application*
Personal Information
Head-to-shoulder photo (ID like photo)*

Please do not wear sunglasses or cap
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ID Card 1st Side or Book*

Please send both sides of the ID Card
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ID Card 2nd Side*

Please send both sides of the ID Card
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Full Names*

Title (Mr/Ms/Dr)First NameMiddle NameSurname
Student Number*
ID Number*
Gender*
Birth Date

MonthDayYear
Ethnicity*
Home Language*
E-mail*
example@example.com
Phone Number*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical history (Optional)
This is optional. However, it would be at our advantage to know more about your conditions.
Parent/Guardian Details
Full Names*

Title (Mr/Ms/Dr)First NameMiddle NameSurname
ID Number*
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Education Background

List your current or previous university/college/schools, beginning with the most recent

University/College Course of Study
Course of Study name*
Funder
Name of funder*
Select the funder
Other
If selected other, please specify the funder
Activity Information
Tell us more about yourself
What activities do you like? What sport do you play?
Residence and room selection
AVAILABLE BEDS

www.cecil-complex.com
Residence*
Select the residence you wish to stay in (browse on the website to make an informative decision)
Room type*
There are no single rooms in other residences, only in Cecil Complex 3 & 5
LEASE AGREEMENT

Please click here to download the lease agreement and read it. You will be requested to sign the lease agreement when taking occupancy, provided your application is successful, with a knowledge that you have read the terms and conditions of the residence.

After completingthis form, make sure you apply on the NSFAS Accommodation Portal as well. Click here:https://xgprod.nsfas.org.za/login
Signature*

Clear
Should be Empty:

Parent/Guardian Details