Baptist Student Hostel Residency Application Form

Personal Application Form for residency at the Baptist Student Hostel

Name:

Home Address:

Birth Date:

Home Phone:

	Email:

Secondary School Attended:

Last Year At School:

Character References are required from two people.
Please give names and addresses and phone numbers of these and ask them to post references directly to the Manager.

Name:

Address:

Phone:

Name:

Address:

Phone:

Place of study:

	Course:

Course duration (weeks):

Any special requirements:

Diet or health etc?:

Any other Comments that you think may assist the Board in coming to a decision:

Car parks will be allocated on application

If accepted, I agree to abide by the rules and conditions of residence of the Hostel:

Applicant's Signature:

Date:

How did you hear about the hostel?:

Signature of parent or guardian:
(if applicant is under 19 yrs of age)

Date:

Notification of Acceptance:

Applications will be processed when recieved
Upon your acceptance, you will be notified and required to pay a deposit to secure your accommodation for the year.

RETURN the completed application form to:

The Manager,
Baptist Student Hostel,
163 Fitzherbert Ave,
Palmerston North.

Prices are quoted in NZD.