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.