Baptist Student Hostel Residency Application Form

Personal Application Form for residency at the Baptist Student Hostel
Name:
Home Address:
Birth Date:
Home Phone:
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 of 2 weeks board 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.