Online Application:

Renter Details
Surname:
First Name(s):
Date of Birth (dd/mm/yyyy):
Drivers Licence:
University (if applicable):
Student Number:
Residential Details
Street Address:
Suburb:
State:
Post Code:
Phone:
Fax:
Mobile:
Email:
Landlord or Real Estate Agent Details If the residence is a rented property, you MUST provide the Landlord, Real Estate Agent or Rental Manager details
Rented property:	Yes No
Surname:
First Name(s):
Street Address:
Suburb:
State:
Post Code:
Phone:
Fax:
Mobile:
Email:
Previous Residential Details Please provide details of your last residential address previous to the address listed above.
Street Address:
Suburb:
State:
Post Code:
Employment Details Please provide details of your employment (if any).
Employer:
Street Address:
Suburb:
State:
Post Code:
Phone:
Fax:
Mobile:
Email:
References or Referees Please provide details of two referees.
Referee #1
Name:
Street Address:
Suburb:
State:
Post Code:
Phone:
Email:
Relationship:
Referee #2
Name:
Street Address:
Suburb:
State:
Post Code:
Phone:
Email:
Relationship:

Co-Renter Details
Surname:
First Name(s):
Date of Birth (dd/mm/yyyy):
Drivers Licence:
Mobile:
Email:
Previous Residential Details Please provide details of your last residential address previous to the address listed above.
Street Address:
Suburb:
State:
Post Code:
Employment Details Please provide details of your employment (if any).
Employer:
Street Address:
Suburb:
State:
Post Code:
Phone:
Fax:
Mobile:
Email:
References or Referees Please provide details of two referees.
Referee #1
Name:
Street Address:
Suburb:
State:
Post Code:
Phone:
Email:
Relationship:
Referee #2
Name:
Street Address:
Suburb:
State:
Post Code:
Phone:
Email:
Relationship:

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