Long Term | WTH official

Applying To Stay

(All the fields with asterisk * are obligatory)

ABOUT YOU

First Name*

Surname*

Religion (Optional)

Date of birth*

**(You must be aged between 18-30)

Nationality*

Mobile Phone Number*

E-mail address*

Passport number*

Coutry of issue*

Passport expiry date*

Visa expiry date (if required)

Date of first arrival to the UK (if required)

ABOUT YOUR STAY AT WTH

Room choice*

Single

Double (female only)

Triple

Quad (male only)

Arrival date*

Departure date*

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!)

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

Please, add details...

Add passport size photo

Read House Rules

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 four months 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.*

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