Application

Please use this application form to apply for a place in the Education City Residential Village.

Your place will be confirmed once your application has been approved. Please be advised that your application will not be processed until information is provided in all mandatory fields.

Should you have any questions or require assistance to complete your application for accommodation, please do not hesitate to contact Donna Reid, Student Accommodation Manager on +61 7 3166 9188 or donna.reid@colliers.com

Family Name:

Given Name(s)

Preferred Name:

Title:

Gender:

Male Female

Date of Birth :

DD/MM/YYYY

Address 1:

Address 2:

City:

Province / State:

Postal Code / ZIP :

Country:

Telephone:

Mobile:

Email:

Alternate Email:

Please answer the following questions in order for Education City to provide you with the most appropriate accommodation to suit your needs. All information provided will be treated as confidential.

Preferred Accomodation 1:

Please Select 2 Bedroom 4 Bedroom 5 Bedroom 6 Bedroom 7 Bedroom

Preferred Accomodation 2:

Please Select 2 Bedroom 4 Bedroom 5 Bedroom 6 Bedroom 7 Bedroom

Please select your preferred share accommodation option:
Male only Female only Male / Female

Will you have a vehicle:

Yes No

Registration Number:

Make / Model:

Education Provider:
USQ Bremer TAFE ACC UIL STS None
Other

Course / Programme Name

Duration:

Please Select 6 Months 12 Months

Arrival Date:

(DD/MM/YYYY)

Departure Date:

(DD/MM/YYYY)

Please indicate who will be responsible for the payment of accounts (e.g. Own Income, Savings, Parent / Guardian, Other) Own Income Parent / Guardian
Other (Please Specify)

Family Name:

Given Name(s):

Preferred Name:

Title:

Address1:

Address 2:

City:

Province / State:

Postal Code / ZIP :

Country:

Telephone:

Mobile:

Email:

Do you have any other requirements or information to assist us with your application?

Medical:

Disability:

Other:

How did you hear about the Education City Residential Village?
Please Select Accommodation Guide Advertisement Faculty Friend International Education Agent USQ International Office Open Day School Sponsor University Prospectus Walk in Website

I certify that the information contained in this application is complete and accurate
 I agree for my Personal Information to be given to USQ Springfield for the Setup of Internet Quotes
*Please place a tick in the box so when it is clicked on, it appears.

Verification Code:

  
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