Carlton Melbourne College - Student Accommodation

to apply for accommodation at CMC, you may either submit this form or print it out and fax it to (61 3) 9842 3813

Given Names
Surname
Preferred Name (if different from above)
Sex
Date of Birth
Passport Number
Address 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
If Twin Share, Specify Name of 2nd Person
Proposed Arrival Date at CMC
Arrival Time
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	Wednesday 10th March 2010

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