Asha House / Stanton Asset Management

waxspadeManagement

Nov 18, 2013 (4 years and 1 month ago)

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Asha House / Stanton Asset Management

Application form 201
3
/ 201
4


Please complete all the fields clearly. All fields marked with * are mandatory

Accommodation

Type of accommodation*:





























































Are you
a re
-
booker
?

Yes

No

About you

*
Your first name













*
Other

name(s)


























*
Your last name
























* Your gende
r

Male


F
emale






*
Your date of birth



/ /






*
Your national insurance number


















































*
Your mobile tel. no (inc. country code)



(




)

































*
Your home tel. number (inc. country code)

(




)

































*
Your email address












































*
Your home address
















































































































* Postcode























Your Guarantor

Next
of Kin
(tick here if same as Guarantor) *


* Relationship to y
ou





















* First name


























* Last name




































* Email address



















































*
H
ome address







































































































* Postcode






















Health & Safety

* Do you have a disability or medical condition which we need to be aware of? Yes

No

If yes please provide details








Next of Kin
(tic
k here if same as Guarantor) *


* Relationship to you





















* First name


























* Last name




































* Email address



















































* Home address







































































































* Postcode




























About Your Requirements

Are you booking as an individual or part of a group
? Individual

Group

Preferred Block/ Apartment/ Room Number












Preferred Floor

High


Low


If you are part of a group, please state the names and room numbers (if known) of the students you would
like to live with:

Name




















Block/ Apartment/ Room Number











Name




















Block/ Apartment/ Room Number











Name




















Block/ Apartment/ Room Number











Name




















Block/ Apartment/ Room Number











Nam
e




















Block/ Apartment/ Room Number












Do you want to live
in

a single or mixed

sex apartment?

Single sex

Mixed sex


Are yo
u an international Student?
(If yes,

your home country
?
)



















A
dditional information you would like us to take into considera
tion when allocating you a room.





































































































































































About your studies

* Where will you be attending?







UCAS number
(1
st

Year Undergraduates)













What are you studying?








What year are you currently studying?









How did you learn about Asha House?













































Choosing How t
o Pay

How would you like to pay your booking fee? * Cheque

Debit Card

Credit Card



Rooms are booked on a first come first serve basis, so please make sure you have made arrange
ments
to pay your booking
fee’s

ASAP to make sure you have secured your room


Signature *


































Date *





/





/










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