Student House Application

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Required*

Name *

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Address *

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Home Phone *

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Mobile Phone

E-Mail *

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Date of Birth *

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Sex * Male Female

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Are you prepared to share a room? * Yes No

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Date from which you would like accommodation *

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Course of Study

Year Level 1st year 2nd year 3rd year Other

Full Time Full Time Part Time

Institution

Campus

Please tell us a little about yourself with respect to family, local community, clubs, schools and church background. *

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What makes you feel that you would enjoy being part of a student house run with a community emphasis? *

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Is there any area of Christian or community involvement that you would like to further pursue during the year? *

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What are your interests, hobbies and sporting aspirations? *

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Are there any particular hopes or aspirations you have for the year you would like to share with us? *

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Please provide names and contact phone numbers of two referees. *

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