Corrimal Anglican Application Form 2017
Surname:
First names:
Nickname/Preferred name:
Date of birth:
Mobile phone number:
Email:
Address 1 (your family address):
Telephone:
Address 2 (your address if different from the above):
Telephone:
Expected Date of Arrival:
(Please note that there are two official move-in times for 2017: Fri 10 th /Sat 11 th and Fri 17 th / Sat 18th /February .
Where are you currently studying/working?
What do you intend to study?
What year of study will you be in?
Name, address & phone number of a relative/friend in Wollongong / Sydney
(who could be contacted in an emergency):
Name & phone number of next of kin
(to be notified in the case of serious illness/accident –incl. country & area codes):
Name & phone number of a referee
(who could speak to us about you)
In what capacity does this person know you?
Please state when would you prefer to come for an interview :-
r late November/ early December
r late January/early February
r No preference
Are there any dates around these times that you are unavailable?
(Please note we do not offer telephone interviews. All applicants wishing to be considered for a place must be willing to attend a face to face interview in Corrimal)
What are your reasons for wanting to live at Corrimal Anglican UniHouse?
Have you lived out of home before? (Please provide a detailed history)
How did you hear about Corrimal Anglican UniHouse? (Please tick or highlight one box below)
r A friend/ family member
r Church/School
r Southern Cross
r Corrimal Anglican Website
r University Accommodation Service (incl. website)
r Other: (please specify)
Are you under medical supervision of any kind?
If yes, please give details:
What do you consider your strengths to be?
What do you see as your weaknesses?
In approx 150 words, please write about yourself – your interests, goals, family, character etc
(take as much space as you like, or complete on a separate page)
Before completing this application form:
· Please ensure that you understand and are willing to abide by Corrimal Anglican’s Expectations as outlined in ‘UniHouse Ministry’ handbook and Internet User agreement.
After completing this application form:
· please return by email to or post to the following address
Corrimal UniHouse
Corrimal Anglican Church
121 Princes Highway
Corrimal NSW 2518
Australia.
· Along with your application, you will need to forward (by mail if you are unable to scan and email) a passport sized photo of yourself.
Once your application is received and processed we will email or telephone you to set up a time for a face to face interview.
www.corrimalanglican.com.au
e:
ph: 4284 4113
121 Princes Highway, Corrimal 2518