Carlton Melbourne College
743-751 Swanston Street, Carlton VIC 3053 Australia
Phone: (613) 9347 3238
Fax: (613) 9842 3813
Email: cmc3053@telstra.com

APPLICATION FOR RENTAL ACCOMODATION
Once completed, please fax to (613) 9842 3813
(please complete in BLOCK LETTERS)

Given Names:

____________________________________________________________________
Surname:

____________________________________________________________________
Preferred Name: ( if different from above )

____________________________________________________________________
Sex:

____________________________________________________________________
Date of Birth:

____________________________________________________________________
Passport Number:

____________________________________________________________________
Addres in Home Country/Town:

____________________________________________________________________
Phone:

____________________________________________________________________
Fax:

____________________________________________________________________
Email:

____________________________________________________________________
Course to be Studied:

____________________________________________________________________
Name of University/Institution:

____________________________________________________________________
Commencement Date of Course:

____________________________________________________________________
Anticipated Date of Completion:

____________________________________________________________________
Type of Room: ( Standard Single / Large Single / Twin Share / Room with Bathroom Facilities)

____________________________________________________________________
If Twin Share, specify name of person you wish to share with:

____________________________________________________________________
Proposed Arrival Date at CMC:

____________________________________________________________________
Arrival Time:

____________________________________________________________________
Estimated Total Duration of Residency at CMC:

____________________________________________________________________
Do you have any Special Needs: ( such as religious, cultural or medical )

____________________________________________________________________
Applicant's Name:

____________________________________________________________________
Signature:

____________________________________________________________________
Date:

____________________________________________________________________
Please note this application is not confirmation of acceptance.
Carlton Melbourne College will process this application form and advise you accordingly.