Application

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Application Form

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Personal details

First Name*

Middle Name

Family Name*

Date of birth*

Family Home Address*

Line 1*:

Line 2:

City:

County/State:

Country:

Postcode*:

Mobile Telephone Number*:

Home Telephone Number:

Email Address:

Gender*:
 Male Female

Ethnic Origin:

UK/International or EU Student:
 UK International EU Student

Please attach a copy of your passport here. If you cannot attach then please contact us as this may delay your application.

Education details

What University / College will you be attending*:

What course will you be on*:

Course length:

Course start and end date*:
start:

end:

Please attach a copy of your course details or proof from the University/ College that you will be attending a course with them here. If you cannot attach then please contact us as this may delay your application.

Accommodation

If you are a UK student will you be using a payment plan? If yes fill out guarantor section.*:
 Yes No

How many people are you booking for?:

What room type do you wish to book please list including a 1st and 2nd choice in case room type has sold out. For example type A or type B.:

Which licence length would you like?*:
 43 weeks 50 weeks

Do you have any special requirements? We may not always be able to accommodate these, however we will try our best.:

Would you like to purchase a welcome pack?:
 Yes No

Payment terms

Do you want to pay the £300 holding fee to secure your room? Please be aware this is non-refundable, however if you do take a licence for the accommodation the holding fee will be deducted from your licence fee or first payment? Please note that whether you are paying in one instalment or by staged payments, as a minimum the remaining balance of your first instalment (having deducted the holding fee) and your damage deposit must be paid at least one month before your licence start date. Uni City Lodge reserve the right to decline the offer of a holding fee and it is purely subject to management discretion:
 Yes No

How will you be paying? We accept Cash, UK Bank transfer, International Bank transfer. All payments will be processed by Uni City Lodge on completion of the application form subject to availability.
 Cash UK Bank transfer International Bank transfer

Guarantor Details (if required)

First Name*

Middle Name

Family Name*

Date of birth*

Age*

Family Home Address*

Line 1*:

Line 2:

City:

County/State:

Country:

Postcode*:

Mobile Telephone Number*:

Home Telephone Number:

Email Address:

Gender:
 Male Female

Ethnic Origin:

Country of Residence:

Time at current address. If less than 3 years give previous address.:

Bank name:

Relationship to applicant?:

Please check the security box below:


Our Welcome Packs are designed to make your move more easy, click below to for details.