Manchester Student Village Application Form 2009/2010

PLEASE COMPLETE THE FOLLOWING IN BLOCK CAPITALS Room Number Form Received

1. Family Name/Surname 10. Dates accommodation required from

12th Sept 09 19th Sept 09

2. First Name/Given Name
Your first rent payment is due one week prior to your contract
start date and must be paid in full by cleared funds or your
3. Title Mr Ms Mrs Miss Other room will be cancelled. Please note 51 week contracts may only
start on 12th Sept 09.

4. Sex Male Female 11. Which University/College will you be attending?

5. Date of Birth D D M M Y Y Y Y
12. What type of student are you? (Please tick)
6. Nationality
12b. International Undergraduate Postgraduate
Foundation Program
7. Home/Permanent Address
12c. Full time student Part time student

12d. Please tick which year applies.

1 2 3 4 pg
Postcode Country

Telephone Number You will need to provide the Letting Officer with a council tax
exemption form confirming your student status within one
Mobile week of taking up residence.

Email
13. Are you? (Please tick)
8. Current Postal Address (if different from above)
A New student to MSV A current resident at MSV

14. How did you hear about Manchester Student Village?

Word of Mouth UCAS Lettings Agent

Postcode Country

Telephone Number Manchester Student Homes Your University/College

Mobile Our Website/Leaflet

Email Other (Please specify)

Would you like your contract sent by: Post Email

15. Where did you live last year? (Please tick)

Dates for this postal address DAY MONTH YEAR Home Manchester Student Village

FROM Private landlord in Manchester

TO University Hall of Residence (Please specify)

(Must be Parent/Guardian/Partner,
9. Emergency Contact Details if you are under 18)

Name Private Halls of Residence in Manchester (Please specify)

What is your relationship?

Address (if different from home address) Other (Please specify)

16. Special Requirements

Postcode Country Do you have any physical or other

special needs requiring specific facilities? Yes No
Telephone Number
If you answered Yes above please give details
Email
16b. Are you registered disabled? Yes No 19b. The £200 can be paid by:
• Cash (only for applications in person)
16c. Are you taking any medication or have an existing medical • Cheque made payable to Manchester Student Village
condition we should be aware of? • Bankers Draft
• Credit or debit card - please complete the details below.
There is a 3% charge for all credit card payments

16d. Are you asthmatic? Yes No

Card Details
17. Preferences (Please indicate first and second choices)
Please choose your preferred flat type
Name on card
Room size 43 weeks 51 weeks
Studio £125 per week £125 per week Card Type Credit Card Debit Card
Kitchen diner £78 per week £78 per week
Grade 1 £74 per week £69 per week Card Number
Grade 2 £72 per week £67 per week
Grade 3 £69 per week £64 per week Start Date Expiry Date

Special purchase £67 per week £62 per week

Issue Number
Please see our website www.mcrstudents.com for full room specifications
If you select a 51 week term please note that you CAN NOT reduce this
length to 43 weeks after you have made your application under any Security Code (last 3 digits on the back of card)
circumstances.
House Number (where the card is registered)
18. Special Requirements
Postcode (where the card is registered)
Same Sex Only Flat No Preference
I agree for £200 to be taken from my card
Smoking Non Smoking

You must provide a preference - if you tick no smoking,

you cannot smoke in the flat. If you opt for smoking - Signature
please note smoking is only permitted in bedrooms.
Date
18b. Do you wish to share with other
Please return this form to:
1st years 2nd years 3rd years / pg The Lettings Officer, Manchester Student Village,
Lower Chatham Street, Manchester M1 5SX, United Kingdom
18c. Do you have any friends you wish to share with?
Telephone: +44 (0) 161 236 1776
Please give their names Fax: +44 (0) 161 236 6045
Email: msv@mcrstudents.com

Cancellation Policy (Please read carefully)

Groups of up to five residents are welcome. Each resident needs
to complete a separate form and all applications should be
stapled and submitted together to avoid disappointment.
PLEASE NOTE WE CANNOT GUARANTEE TO MEET ALL YOUR
PREFERENCES. All rooms are allocated on a first come first served
basis and the largest rooms will be allocated first. Please note
rooms vary in size and shape and there will be some variance
within each grade.
18d. Any changes to your preferences from 10 - 18c may result
in an administration charge and in certain cases may not
be possible.
• Applicants who cancel their application will forfeit £200
• If you are a first year applicant and do not achieve the
required exam results to attend a course in Manchester
you will be released from your Licence Agreement if you
provide copies of your offer letter and proof of grades
within 48 hours of receiving your exam results.
• All successful applicants will receive a licence agreement.
If a signed copy is not received within 6 weeks from the
date it was posted from the Manchester Student Village
Office, along with proof of home address, two passport
sized photographs and guarantor form, your room will be
withdrawn and you will forfeit the £200 deposit.

19. To Apply
A deposit of £200 is payable to reserve a room. The deposit will
be returned within four weeks of the end of the licence
agreement provided there are no damages or outstanding
charges. The deposit DOES NOT include telephone charges,
internet connection fee or tv licence.
• If someone else is paying your deposit please ensure they are
aware of this cancellation policy. Cancellations must be received
in writing and addressed to the Accommodation Manager.
Failure to sign and date this form will delay the processing
of your application.

Manchester Student Village is a

trading name of Willowfox Ltd.
Part of the MCR Group. Signature
Company Registration No.: 5261134
Issue 1 - Dec 2008 Date