Room Booking Confirmation Form
Please Note that all our Accommodations require a minimum deposit amount which is refundable at the end of the year and a R250 admin fee to process and confirm all the tenant data submitted. The Accommodations have different deposit amounts, Please confirm all details with our team first before making any payments.
Client Details
We will use these to stay in touch with you
Name
*
First Name
Last Name
Identity Number
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parents/ Guardian Details
This will help us in cases of emergency
Parent 1/ Guardian 1 Names
*
First Name
Last Name
Parent 1/ Guardian 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2/ Guardian 2 Names
First Name
Last Name
Parent 2/ Guardian 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
School Details
This will help us allocate you to a house accredited by your institution
Name of Institution
*
Please Select
Vaal University Of Technology
North West University Vaal Campus
Sedibeng East College
Student Number
*
Course Name
*
Year of Study
*
First Year
Second Year
Third Year
Fourth Year
6 Month Student
Source Of Funds
*
Please Select
Self Funded
NSFAS
Private Bursary
House and Room Confirmation
This will help us secure your Room from the house Chosen. Please check the following Link for house pictures
Accommodation Name/ Address
*
ATMOFIN House 2 General Froneman
ATMOFIN House 47 Penelope
Atmophin House 70 Hans Van
Bethel House 22 Hugo
Bethel House 24 Hugo
Bethel House 4 Hugo
Bethel House 6 Hugo
Bethel House 45 General Froneman
Bethel House 54 General Froneman
House Peniel No_9
What Type of Room Are you Looking For??
*
Please Select
SIngle Room
Ensuit
Bacheelor
How Did You Find Out About This Accommodation??
*
Please Select
Friend
LandLord
Nthathi (Admin)
Sifiso(China)
Accredited Houses List
AccoBox Connect Website
AccoBox Whatsapp Group
AccoBox Catalogue
I was Just passing By
Document Submission
Please Submit All required Documents
2025 or 2026 Proof Of Registration
Browse Files
Drag and drop files here
Choose a file
A screenshot/ Pdf
Cancel
of
2026 NSFAS/BURSARY Proof of Funding
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Drag and drop files here
Choose a file
Screenshot From NSFAS Portal will do just fine
Cancel
of
Proof of Deposit Payment
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Choose a file
Screenshot/Pdf
Cancel
of
If Deposit was Paid Cash who Did You pay too and how much??
Save
Submit
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