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Apply for Student Accommodation

Personal Details

Family Name

Given Name(s)

Gender

Male Female Other

Date of Birth

Country of Birth

Nationality

Citizenship Status

Citizen Permanent Resident Foreign Student

Email Address

Cell Phone Number

Home Address

Academic Details

Student ID Number (if known)

Proposed course of study

Department / School / College (if known)

Name of Supervisor (if applicable)

Are you receiving a scholarship to study at the University of Canterbury?

Yes No

When you arrive at UC to commence your studies, will it be your first time in New Zealand?

Yes No

When you arrive at UC, at what level of study will you be?

Are you a New Zealand Scholarship (NZS) student?

Yes No

Accommodation Details

Which type of room are you interested in?

Twin Studio Unit Double Studio Unit Two Bedroom Unit

Are you already in Christchurch?

Yes No

Arrival Date (please note the date you require accommodation from)

Anticipated Departure Date

Partner details (if you will be arriving with a partner, or your partner will be joining you soon after your arrival, please provide their details)

Full Name

Gender

Male Female Other

Date of Birth

Country of Birth

Cell Phone Number

Email Address

Children details (if you will be arriving with a child or children, or your child or children will be joining you soon after your arrival, please provide their details)

Child 1

Full Name

Gender

Male Female Other

Date of Birth

Child 2

Full Name

Gender

Male Female Other

Date of Birth

Data Collection Consent

In submitting this form I agree to my details being used for the purposes of arranging accommodation on my arrival in Christchurch. This information will only be accessed by necessary Motel or University staff. I understand my data will be held securely and will not be distributed to third parties, other than for the purposes of confirming my accommodation. I understand that when this information is no longer required for this purpose, my data will be disposed of securely. I declare that the information I have provided is correct.

Security: Security Code