APPLICATION FOR ACCOMMODATION

IN THE HALLS OF RESIDENCE FOR 2011

Continuing Student Late Application
Completed applications can be submitted by:
POST:

FAX:

Student Services
Charles Sturt University
Panorama Avenue
Bathurst NSW 2795

SCAN and EMAIL:

(02) 6338 6599

ask@csu.edu.au

(All details must be completed or application will not be processed. PLEASE PRINT.)

Are you studying at Charles Sturt University for Session 1 in 2011?:

YES

PERSONAL DETAILS:
CSU Student Number:
Title (please circle):

MR / MRS / MS / MISS

Surname:
Given names:
Date of Birth:

________ / ________ / ________

Address:

Contact Phone no.

Other Contact Phone

Email address:

APPLICATION DETAILS:
Please indicate which campus you require accommodation for 2011:
Albury Wodonga
Orange

Bathurst
Wagga Wagga

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Dubbo

NO

CSU Student ID Number (please print): ______________________

Areas you wish to be considered for: (please refer to the accommodation category table and
select in order of preference). All areas marked must be acceptable for 2011. (Do not indicate a
location you would not accept or does not exist on your campus!)
Preferences
Preference One:

Package One, Two or Three

Preference Two:

Package One, Two or Three

Preference Three:

Package One, Two or Three

Preference Four:

Package One, Two or Three

If you have selected a share/twin room or house occupancy as one of your preferences, please indicate the persons
student id number and full name of who you wish to share with (must be of the same sex as yourself if your selection is
a share/twin room):

COURSE DETAILS:
Course Name:
Please specify the classification of your course for 2011:
Undergraduate

Masters

PhD

Graduate
Certificate

Graduate
Diploma

SPECIAL CONSIDERATIONS:
1. Do you have a disability that needs to be considered for room allocation in making this
application?
YES

NO

If yes, please include details on the comments page.

2. Is there any other issue you wish to identify in support of your application for accommodation?
YES

NO

If yes, please include details on the comments page.

APPLICANTS DECLARATION:
In submitting this application, I undertake that if I am successful in obtaining a room I will meet all financial
and administrative commitments as part of this application. I am aware that I will forfeit this room if I do not
meet these requirements. I acknowledge I have accessed the 2011 Administration Regulations and 2011
General
Regulations
(Residential
Regulations,
when
combined)
that
are
located
at
http://www.csu.edu.au/division/studserv/residences/ and undertake to abide by these rules should I be
accepted in the Halls of Residences. I acknowledge that if my application is successful that I am expected to
live on-campus until the end of Session 2 or I will pay the required cancellation fees. I have also noted the
dates in February by which I need to cancel if I intend to receive a refund of any of the upfront/acceptance
charges.

Signature:.. Date: _____ / _____ / _____

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CSU Student ID Number (please print): ______________________

Comments in Support of Application for Accommodation

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