Student Details

Is this a renewal application?*
Which Accommodation do you require?*
What type of room would you prefer?*
How long do you require accommodation for?*
Payment Option*
Any specific requirements?

First Name*
Surname*
Home Address (where you normally reside when not at University)
House Name or No.*
Street*
Town or City*
County*
Country*
Postcode/ZIP*
Telephone No.*
Mobile No.*
Email*
Date of Birth*
Gender*
Nationality*
Religion/Ethnic Origin*
Are you a Full Time Student?*
University*
Year of Study in Sept 2012*
Course*
Term Time Address(if different from above)
House Name or No.
Street
Town or City
County
Country
Postcode/ZIP
Telephone No.

How did you hear about us?*	Other (please state)

Guarantor Details

A Guarantor (usually parent or legal Guardian) must be a permanent resident in the UK. International Students who cannot provide Guarantor must choose payment option ‘B’

Title
First Name
Surname
Relationship to student
Is the guarantor a home owner?
House Name or No.
Street
Town or City
County
Country
Postcode/ZIP
Home Tel No
Mobile No.
Email

I am not a british resident and cannot provide a guarantor who is resident in the UK

Terms and Conditions

Please tick this box to confirm that you have read the Factsheet and understand that completion of an application form does not constitute an agreement to let and availability will be confirmed in due course.

Confirmation*