Accommodation Booking Request form

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					                         Accommodation Booking Request form

Personal details
Address line 1
Address line 2
Suburb/town                                                                             Postcode
State                                                                                   Country
Phone number [preferred]
Email address
Course of study enrolled in or intend to enrol in
        ALC course
        Other university course
        [Boarding only]
Accommodation details
Please note that your accommodation request will be given due consideration by the Business Office;
accommodation is subject to availability

I would like to apply for accommodation at Australian Lutheran College [ALC]

        Single boarding accommodation
        Shared accommodation
        Number of occupants
        Name[s] of additional occupant[s]
        Family accommodation
        Please indicate number, ages and gender of children

All information given to support thi s request, to the best of my knowledge, is correct
Type name for electronic submission
Name/Signat ure                                                                              Date
Return and acknowledgement of form
Please post, return form in person, email or fax to
ALC, Business Office, 104 Jeffcott Street, NORTH ADELA IDE SA 5006; Email:;
Fax: 08 8267 7350
If you do not receive an acknowledgement of the request form within four [4] weeks of submission, please
contact the Business Office on 08 8267 7400, or in person, as a matter of urgency.
Business office use only
Accommodation available                     Yes – details
                                            No – details
Student contacted                           Date
Accommodation confirmed                     Date
Date student/family arriving

QPP/FAMC/ABRF/10.01.01                          Amended date: 30/04/10                              Page 1 of 1
                                  ALC | CRICOS Provider No: 00707J | ACN: 108 602 151