Resident Application

If you wish to download this application form you can fax or email it back to us on +617 40578677 or info@studentlodge.com.au

Downloadable Application Forms;

Application for Resident Accommodation

Mandatory fields are indicated with a *

Applicant Details
Name of Applicant *
Contact Address (when not in residence) *
Car Registration
Car Make and Model
Telephone (Home) *
Telephone (Work)
Fax Number
Email Address *
Student Number (if applicable)
Course of Study (if applicable)
Year of Study *
Name of Home University
Agency
Date of Birth *
Gender	Male Female
Age Now *
Next of Kin (Emergency Contact)
Parent Guardian Details
Name of Parent/Guardian
Address of Parent/Guardian
Parent/Guardian Telephone
Parent/Guardian Fax
Parent/Guardian Mobile

Medical Conditions
Do you have any known medical conditions? *	Yes No
If Yes, Please state the condition (eg. asthma)
What treatment is needed in an emergency?
Name of Doctor
Telephone number of Doctor
Do yo have any alergies?	No Yes
If yes, please explain what allegies you have

Diet
Do yo have any alergies?	No Yes
If yes, please explain what allegies you have
Whilst we endeavour to please, we have to prepare meals for the majority. We do include vegetarian dishes. Please feel free to discuss menus or diets with our staff.

About You
I wish to apply to stay at the Cairns Student Lodge because...
While your requests will be taken into consideration, we cannot guarantee your preferences: Please rate yourself on the following scales:
Study Location Preferences
Political Preferences
Personal Quietness
Personal Neatness
Religiously Observant
Do you smoke?
Would you live with a smoker?
Clusters and floors can be reserved for Female Students only. Please indicate whether you would prefer this option:	Yes No
I wish to apply for Semester	1st Semester 2nd Semester
I wish to apply for Semester Year
I will be paying for my account every	Two weeks Semester in advance
Please let us know how you found out about "Cairns Student Lodge"	JCU Townsville JCU Cairns Other University Website Television Newspapers Agency Word of Mouth Other
Declaration
I understand that by submitting this application I am applying for accommodation at Footprints Cairns Student Lodge and if admitted I may be obliged to pay residential fees for the full semester period and abide by The Cairns Student Lodge Handbook. I acknowledge that Footprints Cairns Student Lodge has the right to reject my application. All information on this application is true and correct to the best of my knowledge.
This application will be considered and we hope we can offer you a placement.

International Student Payments

All international Students MUST pay all fees and accommodation charges for the semester in advance. If you wish to pay fortnightly you will need to arrange automatic direct debit into Cairns Student Lodge Pty Ltd Account. Details are as follow;

NAME: Source Student Lodge Pty Ltd
BANK: Suncorp
BSB: 484 799
ACC: 451 081 071
SWIFTCODE: METWAU4B

You will need to ask the bank to use your name as a reference for the direct credit payment so we can track who
the money is coming from.

Please forward applications to;

Cairns Student Lodge
10-24 Faculty Close,
SMITHFIELD AUSTRALIA 4878