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Name
Surname
Preferred Name
Gender
Date of Birth
Home Address
Country
Postal Code
Phone
Email
Type of course
Name of University or Institution

Student ID # (if known)
Commencement Date of Course
Anticipated Date of Completion
Room Type
If Twin Share, specify name of second person
Proposed arrival date at CMC

Arrival time
Estimated Total Duration of Residency at CMC

Other

Do you have any special requests? (Religious, cultural or medical)

*Please note this application is not a confirmation of acceptance. Carlton Melbourne College will process this application form and will advise you accordingly.

COVID Rental Accommodation Assistance from $150 per week*

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