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Full Name (*)

University/Campus (*)

Your Address (*)

Phone No (*)

Street Address (*)

City/Province/Region (*)

State (*)

Country (*)

Your Email (*)

Gender (*)

Age (*)

Parents Guardians Name (*)

Parents Guardians Address (*)

Parents Guardians Phone No (*)

Do you smoke (*)

Would you prefer to stay with (*)

Would you prefer to stay with (*)

Flatmates Preference (*)

Rate Yourself, from very quite to very social (*)

Your religion

Prefer to Stay with as same as your religion

Lengh of stay (*)
1st Sem only (21th Jan - 14th July) 2nd Sem only (15th July - 31st Dec) Both (1st & 2nd Sem) (21st Jan - 31st Dec) 

Unlimited Broadband extra $10 per week (*)

Require Linen Pack? (*)

Require Car Park? (*)

Additional Information regarding flatmates you would prefer to stay with

 
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