Student Accommodation Application

Student Accommodation Application

Resident and Room Details
Full Name as shown on Passport*

First NameLast Name
E-mail*
example@example.com
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemale
Mobile Number*

Area CodePhone Number
Nationality*
Passport Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Course Name
Course Type

VocationalEnglish LanguageUndergraduatePostgraduatePHD
University/Institute
Do you have a Confirmation of Enrolment (CoE)?*

YesNo
If Yes, Please input your Confirmation of Enrolment (CoE) Details
What is your current visa status?*

Not Yet AppliedAppliedApprovedRejected
Room Type
Did a migration agent help you with your application?*

YesNo
Type a question
Please select your migration agent below:*
Arrival Date*

DayMonthYear
Departure Date*

DayMonthYear
Free Pickup?*

Yes Please! - Pick me up on arrivalNo Thanks - I'll make my own way there
Arrival Date & Time*

MonthDayYear
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Hour MinutesAM/PM Option

Student Accommodation Reservation Deposit*

Reservation DepositAmount payable to reserve student accommodation

$1,035.00AUD

Subtotal

$0.00AUD

Tax

$0.00AUD

Total

$0.00AUD