Accommodation Placement Application

If you would like to apply for JCU Brisbane student accommodation placement, please complete the below form. There is a $A220 fee for this serivce and your application cannot be actioned until you have accepted an offer of a place at JCU Brisbane and receipt of the relevant fees is confirmed. (Please Note: if you want to pay by credit card, you must download the pdf, fill it in, sign it and mail or fax it to JCU Brisbane).

Family Name *

Given Names *

Date of Birth *

Gender

Male Female

Number / Street *

Suburb / City *

State / Country *

Postcode *

Telephone *

Facsimile

Email *

JCUB Offer Number *

ACCOMMODATION PREFERENCES

Preferred accommodation type? * From To:
Homestay(min. 4 weeks)
Preferred Residence (from $A200 per week)
Hostel (from $A100 per week / $A20 a night)

Please select preferred zone? * 1-2 zones (up to 30 minutes) from the campus - Cost $A220 per week.
3-4 zones (up to 40 minutes) from the campus - Cost $A200 per week.

For Home Stay Only:

Do you wish to live with family with school age children? * Yes No Don't Mind

Are you willing to live in a home that has pets (eg. cat / dog)? * Yes No Don't Mind

Do you smoke? * Yes No

Do you have any allergies?

(If none, please type 'No')

Do you have any special food needs?

(If none, please type 'No')

Do you have any special health problems?

(If none, please type 'No')

Do you have any other special Homestay requirements?

(If none, please type 'No')

PAYMENT DETAILS *
You will need to make a payment of: $A220 Accommodation Placement Fee, Plus 2 weeks rent in advance (either 2 x $A200 or 2 x $A220). You would like to pay by:
Bankdraft I will forward a bankdraft made payable to 'Russo Higher Education' for the above amount. Send to: James Cook University Brisbane 349 Queen Street, Brisbane QLD 4000 Australia	Electronic Funds Transfer I will transfer the amount by EFT to: Russo Higher Education National Australia Bank Brisbane Queensland Australia 4000 BSB Number - 084-009 Account Number - 588371207	Credit Card Please contact me for credit card details.

ARRIVAL DETAILS

If your arrival details are not yet known please contact us to advice us as soon as they are finalised.

Arrival Date / Time

(dd/mm/yyyy hh:mm AM/PM)

Airline

Flight Number

DELCARATION *

I declare that the information I have supplied on the application form is, to the best of my knowledge, complete and correct. I have read and understood the JCU privacy policy. I have also read information relating to conditions of enrolment and understand that by signing this agreement I am bound by the rules and regulations of James Cook University (JCU) and the Education Services for Overseas Students (ESOS) Act 2001.

I Agree I Do Not Agree

Accommodation Placement Application

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