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 name*
- Graduated*
  
  YesNo
- Year of study*
  
  1st Year2nd Year3rd Year4th YearHonorsMastersPHDProfessorship
- Entry date*
  
  MonthDayYear
  Date
- Graduation date
  
  MonthDayYear
  Date
- School name
- Entry date
  
  MonthDayYear
  Date
- Exit date
  
  MonthDayYear
  Date
- 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
  
  Please click on the website link below to view the pictures of the Cecil Complex residences.
  
  www.cecil-complex.com
  
  Provided you do not want to apply for the available space on the below residences, please click to be on the waiting list.
- Waiting list or Continue with application*
- 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
- LEASE AGREEMENT
  
  After completing this form, make sure you apply on the NSFAS Accommodation Portal as well. Click here:https://xgprod.nsfas.org.za/login
  
  Lease Agreement shall be signed online on the NSFAS Accommodation Portal.
- Signature*
  
  Clear
- Referred by who?
- Should be Empty:

Cecil Complex Student Accommodation Application Form

Year of Application

Personal Information

Parent/Guardian Details

Education Background

Funder

Activity Information

Residence and room selection