Accommodation Application Form for Emalus Campus

Student ID Number *

Date of Birth *

Full Name *

Email *

Phone

Residential Address *

Gender *

Others

Programme

Major 1

Major 2

Minor

Emalus Campus *

Source of funding: *

Sponsor Details:

Are you: *

Briefly provide your background and reason for requesting to reside in the Halls of Residence *

List any Medical condition you may have

(To be filled by Students who lived on campus in the last Semester of this year)

Current Halls Room Number

How did you contribute to an atmosphere of study, peace and community in the Halls this year?

Indicate the reasons you wish to be considered for residential accommodation

How will you contribute to an atmosphere of study, peace and community if you are provided with accommodation?

Spouse Name

Occupation

an may Layout

Number of children accompanying you

I hereby declare that if I am selected:

I will remain in the Halls of Residence for the duration of one/two semesters
If for any reason, I decide to withdraw from the Halls, it will be my responsibility to fill the vacated room or forfeit the balance of the accommodation charges to cover the remainder of the semester
I will be subjected to a 25% overhead charge and a withdrawal fee, if I vacate the room after Week 1 of the semester

I will obtain written approval from my sponsor before I am allowed to withdraw from the Halls of Residence (First Years Only)

Signature *

Clear Signature

Date *