Contact

Full name STUDENT DETAILS

Gender

Date of Birth

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Contact Details

Year of Study

Student Number

Course Name

Student's Address

Have you applied at university accommodation Have you applied at university accommodation *YesNo

Are you a returning student to the accommodation? Are you a returning student to the accommodation? *YesNo

Expected date of arrival

Special medical condition/Allergies

Full name GUARDIAN/ NEXT OF KIN DETAILS

Nature of relationship with next of kin

Contact Details

Physical address

Are you NSFAS Accredited PERSON/INSTITUTION RESPONSIBLE FOR PAYMENT Are you NSFAS Accredited *YesNo