MILLENNIUM INVESTMENTS 2000 LIMITED FOREST ROAD HOUSE, FOREST ROAD, COLCHESTER, ESSEX, CO4 3XA  TEL: 01206 500202  FAX: 01206 500186  E-mail: enquiries@forestrd.co.uk

APPLICATION FOR ACCOMMODATION - FOREST ROAD HOUSE

Surname / Family name:
First Names:
Home Address:
Post Code:	Telephone Number:
E-Mail Address:
Current Accommodation:
Nationality:	Male Female DOB (DDMMYYYY):   Age:
University Information
Degree Scheme:
What department do you belong to ?:
	Post Graduate   Undergraduate       of Year:
	Self Funding     Student Loan    Other:
Accommodation
Do you require accommodation for:	(minimum term) 11 months    1 Year
Do you smoke ?:	Yes    No
Would you prefer a single sex flat ?:	Yes    No
Preference to which room you are allocated ? (this is on first come first served basis):
Have you enclosed your advance booking fee and administration fee for advance booking?  :
(Advance booking fee of £250 plus £60 administration fee)   -    Yes    No
If yes, by what payment method ? :
	Cash Cheque Bank Transfer Credit Card Other
Do you wish to pay on a monthly basis (additional admin fee of £55 required) ? :    Yes    No
Please note all cheque's should be made out to 'Millennium Investments 2000 Ltd'.
In the event of cancellation the advance booking fee and administration fee will not be refunded. On the grant of an Assured Shorthold Tenancy to you the advance booking fee will be immediately credited against the first rental instalment due under the Tenancy. Reserved rooms will be held until the 5th October after which date any reservation will be deemed cancelled and the room reallocated where required unless prior arrangements have been made for late arrival. By completing this application you acknowledge and agree that ‘Millennium Investments 2000 Ltd’ reserves the right to share any of the above information with the University of Essex. I confirm that I am in full time education. By signing this application form, you agree to the terms above.
Signed by Applicant: