Residence Application Student

Your Name (required)

Your Email (required)

Your Telephone (required)

Address of property to rent
Flat 1 63 Ash Grove Hyde Park LS6Flat 2 63 Ash Grove Hyde Park LS6Flat 3 63 Ash Grove Hyde Park LS61 Falmer Cottage (4 Bed) Hyde Park LS62 Falmer Cottage (5 Bed) Hyde Park LS61 Moorland Avenue (6 Bed) Hyde Park LS62 Broomfield Terrace (3 Bed) Headingley LS62 Brudenell View (4 Bed) Hyde Park LS628 Brudenell Mount (5 Bed), Hyde Park Leeds LS629 Welton Place (3 Beds) Hyde Park LS643 Brudenell Road (7 Bed) Hyde Park45 Brudenell Road (7 Bed) Hyde Park LS6 Fully Let52 Brudenell Road (8 Bed) Hyde Park LS660 Headingley Avenue (4 Bed) Headingley LS6

Agreed rent (per calendar month)

Student number

University

Campus

Course

Course start date

Course finish date

Emergency Contact/ next of kin

Emergency Contact telephone number:

Emergency Contact email:

Emergency contact Address:

Proof of ID (copy of drivers licence/ passport)

I hereby delcare that all the information is correct and true

signed (required)