Application Form

You must complete the application form so we can begin processing your booking. When we receive your application form, we will send you a tenancy agreement via email for you to read and sign. Completing this form does not bind you into a contract at this stage.

Application Form

Preferred Room Type:

Preferred Move In Date

DD/MM/YY

Your Full Name:

First Name

Last Name

Gender:

Your Date of Birth

DD/MM/YY

Mobile Number

Home Tel. Number

E-Mail Address:

Home Address

Emergency / Nominated Contact

Note: In the event of emergency, we have your permission to contact this person on your behalf.

Full Name:

First Name

Last Name

Relationship To You:

Email Address:

Contact Number

Home Address

Health & Safety

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

If "Yes", please provide details below:

About Your Requirements

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

Preferred Floor:

Do you want to live in a single or mixed sex apartment?

Are you an international student?

If "Yes", what is your home country?

Is there additional information you would like us to take into consideration when allocating you a room?

About your studies

Where will you be attending?

Your UCAS Number / Student ID

What are you studying?

Which year will you be studying whilst at Asha House?

How did you learn about Asha House?

Choosing How to Pay

How would you prefer to secure your room?

Note: No payment is required or taken at this point.

All fields marked with * are mandatory.

Application Form

ASHA HOUSE

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