Accommodation Application

Official enrolment and placement enquiry form.

Application For

Preferred Move-in Date

First Name(s)

Surname

Institution / University

Mobile Phone

Email Address

Room Type Preference

Placement is subject to residence availability.

Source of Funding

Next of Kin Full Name

Relationship

Next of Kin Phone

Alternative Phone

Street Address

Suburb / Village

Town / City

Province

Postal Code

Applicant E-Signature

Sign above using your finger, mouse or stylus.

Need help with your application or want to book a viewing? Contact Embizeni directly.