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    Student Housing Reservation Form Spring: 1. Personal Details (Passport Details)

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    b0lg3r
    This student housing reservation form must be completed on a computer and include a passport copy. It requests information such as personal details, contact information, insurance coverage, arrival/departure dates, and a signature accepting the conditions. The closing date to submit the form is November 15, 2010.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Student Housing Reservation Form Spring: 1. Personal Details (Passport Details)

    Uploaded by

    b0lg3r
    54 views4 pages
    This student housing reservation form must be completed on a computer and include a passport copy. It requests information such as personal details, contact information, insurance coverage, arrival/departure dates, and a signature accepting the conditions. The closing date to submit the form is November 15, 2010.

    Original Title

    Housing_reservation_form_Spring_2011

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    © Attribution Non-Commercial (BY-NC)

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    This student housing reservation form must be completed on a computer and include a passport copy. It requests information such as personal details, contact information, insurance coverage, arrival/departure dates, and a signature accepting the conditions. The closing date to submit the form is November 15, 2010.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    54 views4 pages

    Student Housing Reservation Form Spring: 1. Personal Details (Passport Details)

    Uploaded by

    b0lg3r
    This student housing reservation form must be completed on a computer and include a passport copy. It requests information such as personal details, contact information, insurance coverage, arrival/departure dates, and a signature accepting the conditions. The closing date to submit the form is November 15, 2010.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 4

    Student housing reservation form

    Spring 2011

    This form is only accepted if completed on a computer and including the required copy of your
    passport. 2 passport size pictures can be send by post. Closing date is 15 th November 2010

    1. Personal details (passport details)

    Family name: ………………………………………………………………….


    First name(s): ………………………………………………………………….
    Date of birth: ..……………………………………………………….............(dd/mm/yyyy)
    Place and country of birth:…………………………………………………………………..
    Nationality: ……………………………..……………………………………
    Gender:  Female  Male

    2. Contact details (permanent address)


    Address: ……………………………………………………………………
    Postal code: ……………………………………………………………………
    City: ……………………………………………………………………
    Country: ……………………………………………………………………
    Telephone incl. land code:…………………………………………………………………
    E-mail *): …………………………………………………………………..
    *) Note that all information is sent through E-mail

    3. Contact person in case of emergency

    Family name: ………………………………………………………………….


    First name(s): ………………………………………………………………….
    Address: ……………………………………………………………………
    Postal code: ……………………………………………………………………
    City: ……………………………………………………………………
    Country: ……………………………………………………………………
    Telephone incl. land code:…………………………………………………………………
    E-mail: …………………………………………………………………..

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    4. Contact details home university
    Name of university: …………………………………………………………………….
    Study area: …………………………………………………………………….
    Contact person: …………………………………………………………………….

    5. Enrolment details Applying for study area:

    O International Service Management (IBB) O Logistics and Transport Management (IBB)


    O Architecture (IBB)

    O International Business Experience (IBEX) O International Business and Career (IBaC)

    O Primary Education (IVL PABO) O Secondary education (IVL LERO)

    O International Business and Management Studies (RBS)

    O Pre-IBMS (RBS) O Business Graduate (RBS)

    O International Class 3 months (School of Education or School of Social Work)

    O International Class 5 months (School of Education or School of Social Work)

    O Willem de Kooning Academy O Other, please specify:….

    6. Insurance is required

    I am insured against:
    Medical and repatriation expenses  Yes /  No
    Liability  Yes /  No
    Burglary, theft and loss  Yes /  No

    Name of insurance company…………………………………………………………………….

    7. Dates
    Date of arrival: …………………………………………………………………….dd/mm/yyyy
    Date of departure: …………………………………………………………………… dd/mm/yyyy

    8. Special request* …………………………………………………………………….

    * Enter here: a shorter stay than 5 months, floor, room, gender of roommate, name of roommate etc.
    Please be aware that we will always attempt to accommodate your special requests: specific rooms, room types,
    floor, location and flat mates. However, we simply can not guarantee requests due to situations that may arise
    beyond our control.

    2 of 3
    9. Signature

    I have read, fully understand and accept the conditions and consequences contained
    in the Housing Information Fall 2010.

    Place Date

    …………………………………………… …………………………………………. dd/mm/yyyy

    Signature of the student (in case you are not able to scan this form your name is sufficient)

    ………………………………………………………………………………………………………

    3 of 3
    To complete your reservation a deposit is mandatory. All reservations and deposits received
    after the deadline are put on the waiting list. In that case housing cannot be guaranteed.
    Students need to register and unregister with the municipality when renting in Rotterdam.

    This form should be returned to:

    Student Housing Office


    Kralingse Zoom 91 | 3063 ND | Rotterdam
       +31 (0) 10 7946347/ 6237
    Ê +31 (0) 10 7946208 
     StudentHousingOffice@hro.nl
     www.hro.nl/studenthousingoffice

    This form is only accepted if completed on a computer and including the required copy of
    your passport. Closing date is 15th November 2010.

    4 of 3

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