Manchester Student Village

Manchester Student Village

Application Form 2009/2010

PLEASE COMPLETE THE FOLLOWING IN BLOCK CAPITALS

12th Sept 09

2. First Name/Given Name Mr

Ms

4. Sex

Mrs

Miss

Male

5. Date of Birth

D

Form Received

10. Dates accommodation required from

1. Family Name/Surname

3. Title

Room Number

Your first rent payment is due one week prior to your contract start date and must be paid in full by cleared funds or your room will be cancelled. Please note 51 week contracts may only start on 12th Sept 09.

Other

Female

D

M

M

Y

19th Sept 09

11. Which University/College will you be attending?

Y

Y

Y 12. What type of student are you? (Please tick)

6. Nationality

12b. International Undergraduate Foundation Program

Postgraduate

7. Home/Permanent Address 12c. Full time student

Part time student

12d. Please tick which year applies. 1 Postcode

2

3

4

pg

Country You will need to provide the Letting Officer with a council tax exemption form confirming your student status within one week of taking up residence.

Telephone Number Mobile Email

13. Are you? (Please tick) 8. Current Postal Address (if different from above)

A New student to MSV

A current resident at MSV

14. How did you hear about Manchester Student Village? Postcode

Word of Mouth

Country

UCAS

Telephone Number

Manchester Student Homes

Mobile

Our Website/Leaflet

Email

Other (Please specify)

Would you like your contract sent by: Post

Lettings Agent Your University/College

Email 15. Where did you live last year? (Please tick)

Dates for this postal address

DAY

MONTH

YEAR

Home

Manchester Student Village

FROM

Private landlord in Manchester

TO

University Hall of Residence (Please specify)

9. Emergency Contact Details

(Must be Parent/Guardian/Partner, if you are under 18)

Private Halls of Residence in Manchester (Please specify)

Name What is your relationship? Address (if different from home address)

Other (Please specify)

16. Special Requirements Postcode

Country

Do you have any physical or other special needs requiring specific facilities?

Yes

Telephone Number Email

If you answered Yes above please give details

No

16b. Are you registered disabled?

Yes

No

16c. Are you taking any medication or have an existing medical condition we should be aware of?

16d. Are you asthmatic?

Yes

19b. The £200 can be paid by: • • • •

Cash (only for applications in person) Cheque made payable to Manchester Student Village Bankers Draft Credit or debit card - please complete the details below. There is a 3% charge for all credit card payments

No Card Details

17. Preferences (Please indicate first and second choices) Please choose your preferred flat type Room size

43 weeks

51 weeks

Studio

£125 per week

£125 per week

Kitchen diner

£78 per week

£78 per week

Grade 1

£74 per week

£69 per week

Grade 2

£72 per week

£67 per week

Grade 3

£69 per week

£64 per week

Special purchase

£67 per week

£62 per week

Please see our website www.mcrstudents.com for full room specifications If you select a 51 week term please note that you CAN NOT reduce this length to 43 weeks after you have made your application under any circumstances.

Name on card Card Type

Credit Card

Debit Card

Card Number Start Date

Expiry Date

Issue Number Security Code (last 3 digits on the back of card) House Number (where the card is registered)

18. Special Requirements Postcode (where the card is registered) Same Sex Only Flat

No Preference

Smoking

Non Smoking

I agree for £200 to be taken from my card

You must provide a preference - if you tick no smoking, you cannot smoke in the flat. If you opt for smoking please note smoking is only permitted in bedrooms.

Signature Date

18b. Do you wish to share with other Please return this form to: 1st years

2nd years

3rd years / pg

18c. Do you have any friends you wish to share with? Please give their names

The Lettings Officer, Manchester Student Village, Lower Chatham Street, Manchester M1 5SX, United Kingdom Telephone: +44 (0) 161 236 1776 Fax: +44 (0) 161 236 6045 Email: [email protected] Cancellation Policy (Please read carefully)

Groups of up to five residents are welcome. Each resident needs to complete a separate form and all applications should be stapled and submitted together to avoid disappointment. PLEASE NOTE WE CANNOT GUARANTEE TO MEET ALL YOUR PREFERENCES. All rooms are allocated on a first come first served basis and the largest rooms will be allocated first. Please note rooms vary in size and shape and there will be some variance within each grade. 18d. Any changes to your preferences from 10 - 18c may result in an administration charge and in certain cases may not be possible. 19. To Apply A deposit of £200 is payable to reserve a room. The deposit will be returned within four weeks of the end of the licence agreement provided there are no damages or outstanding charges. The deposit DOES NOT include telephone charges, internet connection fee or tv licence. Manchester Student Village is a trading name of Willowfox Ltd. Part of the MCR Group.

• Applicants who cancel their application will forfeit £200 • If you are a first year applicant and do not achieve the required exam results to attend a course in Manchester you will be released from your Licence Agreement if you provide copies of your offer letter and proof of grades within 48 hours of receiving your exam results. • All successful applicants will receive a licence agreement. If a signed copy is not received within 6 weeks from the date it was posted from the Manchester Student Village Office, along with proof of home address, two passport sized photographs and guarantor form, your room will be withdrawn and you will forfeit the £200 deposit. • If someone else is paying your deposit please ensure they are aware of this cancellation policy. Cancellations must be received in writing and addressed to the Accommodation Manager.

Failure to sign and date this form will delay the processing of your application.

Signature

Company Registration No.: 5261134

Issue 1 - Dec 2008

Date