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APPLICATION FORM
CONTACT-US
to apply for accommodation at CMC, you may either submit this form or
print
it out and email it to cmc3053@telstra.com .
Given Names
Surname
Preferred Name
(if different from above)
Sex
Male
Female
Date of Birth
01
02
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21
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26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
Passport Number
Address in Home Country/Town
Phone
Fax
Email
Course to be Studied
Name of University/Institution
Commencement Date of Course
01
02
03
04
05
06
07
08
09
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11
12
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15
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17
18
19
20
21
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23
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25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2024
2023
2022
2021
2020
2019
2018
Anticipated Date of Completion
01
02
03
04
05
06
07
08
09
10
11
12
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15
16
17
18
19
20
21
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23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2024
2023
2022
2021
2020
2019
2018
Type of Room
Single
Large Single
Twin Share
Room with Bathroom Facilities
If Twin Share, Specify Name of 2nd Person
Proposed Arrival Date at CMC
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2024
2023
2022
2021
2020
2019
2018
Arrival Time
01
02
03
04
05
06
07
08
09
10
11
12
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
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41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
AM
PM
Estimated Total Duration of Residency at CMC
(eg. 5 months, etc)
Do you have any Special Needs
(such as religious, cultural or medical)
Applicant's Name
Date
Saturday 24th February 2018
Please note this application is not confirmation of acceptance.
Carlton Melbourne College will process this application form and advise you accordingly.