Long Term | WTH official

ABOUT YOU

First Name

Surname

Gender

Religion (Optional)

Date of birth

Nationality

Mobile Phone Number

E-mail address

Passport number

Coutry of issue

Passport expiry date

Visa expiry date

Date of first arrival to the UK

ABOUT YOUR STAY AT WTH

Room choice

Single

Double (female only)

Triple

Quad (male only)

Arrival date

Departure date

Have you applied before to stay at WTH?

How did you hear of WTH?

Add details of "Other"or if you have any comments, such as the name of the person who recommended you WTH

Why would you like to live at WTH?

ABOUT YOUR COURSE
(You must be a full-time student!)

Undergraduate or Postgraduate?

Choose the college you will be attending

If you chose "Other" above, or you have any comments, please add below

Course name

Registration date

Duration of your course

ADDITIONAL INFORMATION

Current address

Current phone number

Home address

Home Phone number

EMERGENCY CONTACT DETAILS

Please note: Your emergency contact has to be somebody that you are happy for us (or a medical professional) to contact in the event of an emergency

Name and surname

Phone number (add country prefix if needed)

Address

E-mail address

Relationship

Languages spoken

OTHER INFORMATION

Do you have any needs relating to a medical condition or disability?

Yes

No

Please, add details...

Add passport size photo

By submitting this application form you agree to the following declaration: I confirm that I will be a full-time student and over 18 upon my arrival. I wish to apply for a place as a resident of William Temple House, understanding that this application does not guarantee me a place. If accepted as a resident of William Temple House, I will keep to the House Rules which I have read and understood. I accept that my residency can be terminated if I am in breach of the House Rules or for any other reason determined by the Warden. I accept that if I should cease to be a resident of William Temple House within sixteen(16) weeks of arrival or do not take up residency within one week of my stated date of arrival, I will lose my deposit. I confirm that I will be a full-time student for the duration of my residency at William Temple House.

William

TEmple

House

Applying To Stay