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Residence Re-Application Process for Accommodation - 2012 To Apply Lodge a completed Residence Application 2012 form at the Res 4 Office in Drop Off Box no later than the 14 th October, 2011. Applications will not be accepted after the closing date. The Application form & the Conditions of Residency can be downloaded from the T Drive from the 19 September 2011. Incomplete Application forms will not be considered. The Residence Application 2012 form must include: Proof of payment of the residency deposit R2500.0 0 for current On & Off campus students. (Off Campus refers to Honey Park). Proof of payment of the residency deposit R4000.00 for new applications. (Students who are applying for accommodation for the 1st time). Proof of sponsorship letter (if you are a sponsored student). Signed last page only of Conditions of Residency. Fees statement (2011), with R0 balance or a credit balance. Students will be notified by email a letter of the outcome of their application (unsuccessful or conditional offer) from the 30 November 2011. Accepting a conditional offer: Accommodation will only be secured when an official Offer Letter is issued from the 30 November 2011, once payment of the full accommodation fee has been paid on or before the 31 January 2012. This deadline cannot be extended. Fax proof of payment to the attention of Residence Department on +27 11 950 4211. Submitting an application form does not guarantee that you will be offered accommodation. Very Important: If you do not provide proof of payment of the full accommodation fee by the 31 January 2012 your Conditional Offer will lapse. Eligibility Applications from students who have received a disciplinary warning(s) (verbal and/or written) will not be considered. Consideration will be given to students who have made early payment of the full accommodation fee. Incomplete Application forms will not be considered. Timelines Last day to lodge an application form at Res 4 Office in Drop Off Box 14 October 2011 Outcome letter (unsuccessful or conditional) sent to students via their Monash email addresses. 30 November 2011 Last day to pay full accommodation fee. 31 January 2012 Full offer letters will be sent from the 15 November 2011 on condition of full payment & Enrolment.

Application Process and Application Form 2012

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Page 1: Application Process and Application Form 2012

Residence

Re-Application Process for Accommodation - 2012

To Apply

� Lodge a completed Residence Application 2012 form at the Res 4 Office in Drop Off Box no later than the 14th October, 2011. Applications will not be accepted after the closing date.

� The Application form & the Conditions of Residency can be downloaded from the T Drive from the 19 September 2011.

� Incomplete Application forms will not be considered.

� The Residence Application 2012 form must include:

� Proof of payment of the residency deposit R2500.00 for current On & Off campus students. (Off Campus refers to

Honey Park).

� Proof of payment of the residency deposit R4000.00 for new applications. (Students who are applying for

accommodation for the 1st time).

� Proof of sponsorship letter (if you are a sponsored student).

� Signed last page only of Conditions of Residency.

� Fees statement (2011), with R0 balance or a credit balance.

� Students will be notified by email a letter of the outcome of their application (unsuccessful or conditional offer)

from the 30 November 2011.

Accepting a conditional offer:

� Accommodation will only be secured when an official Offer Letter is issued from the 30 November 2011, once payment of the full accommodation fee has been paid on or before the 31 January 2012.

� This deadline cannot be extended. � Fax proof of payment to the attention of Residence Department on +27 11 950 4211. � Submitting an application form does not guarantee that you will be offered accommodation.

Very Important: If you do not provide proof of payment of the full accommodation fee by the 31 January 2012 your Conditional Offer will lapse.

Eligibility

� Applications from students who have received a disciplinary warning(s) (verbal and/or written) will not be considered.

� Consideration will be given to students who have made early payment of the full accommodation fee. � Incomplete Application forms will not be considered.

Timelines

Last day to lodge an application form at Res 4 Office in Drop Off Box 14 October 2011 Outcome letter (unsuccessful or conditional) sent to students via their Monash email addresses.

30 November 2011

Last day to pay full accommodation fee. 31 January 2012 Full offer letters will be sent from the 15 November 2011 on condition of full payment & Enrolment.

Page 2: Application Process and Application Form 2012

Monash South Africa, 144 Peter Road, Ruimsig, South Africa,

Private Bag X60, Roodepoort, 1725,

Telephone +27 11 950 4193 facsimile +27 11 950 4211 Two copies of passport sized photos to be stapled here.

Please ensure that they are attached firmly.

RETURNING STUDENTS: ON-CAMPUS AND OFF-CAMPUS RESIDENCE APPLICATION FORM PLEASE NOTE THAT THIS APPLICATION IS NULL AND VOID IF NOT ACCOMPANIED BY PROOF OF RESIDENCE DEPOSIT PAYMENT

In order for your application to be processed all questions must be answered

I understand that consideration of this application is conditional upon my continuing enrolment as a student of Monash South Africa throughout my period of study. I also accept the right of an authorized

representative of Monash South Africa to access my academic results whilst I remain in residence. I understand and accept that Monash South Africa has offered me accommodation on the condition that I

remain a full time student throughout the year. If accepted I agree to abide by the conditions of residency of Monash South Africa and the Accommodation Fee Regulations for my year(s) of study, and with

other such regulations and rules as are specified in the Monash South Africa Student Resource Guide. I agree to pay all requisite fees and invoices at the time specified.

SIGNATURE ____________________________ DATE ___________________________

(UNSIGNED APPLICATIONS WILL NOT BE ACCEPTED)

Student Number Surname

Given Names

Date of Birth Male Female Nationality

Country of Permanent Residence

Mobile No. Home No. Code No.

Please indicate which Residence:*Subject to availability*

Please note that Residence 6 and Off-Campus are Privately Owned.

Residence 1,2,3

R 17,405 per Semester

Residence 4

R14, 610 per Semester

Off Campus – Honey Park R19,000 per Semester

Managed by Monash South Africa’s Residence Department

Monash Residence Services will be contacting you via e-mail. Please indicate these contact details below.

Email (compulsory)

Proposed Course Faculty:

Government Sponsor / Private Sponsor / Agent Details

Failure to submit these details will result in you not securing your place for accommodation

Private Sponsored Name of Private Sponsor

Contact Phone No. (include Country and Area Code)

Name of Sponsor / Agent

Contact Phone No. (include Country and Area Code)

Postal Address

Emergency Details

In an emergency, I hereby grant Monash South Africa or their nominee, the authority to contact the person(s) detailed here under.

Name Address

Phone No. Relationship (e.g. Father, guardian etc.)

Do you have any allergies or are you on any chronic medication

Conditions Applicable for On-Campus Residence

Accommodation is limited and allocated on a first come first serve basis, subject to the conditions detailed below:

1. Applications must reach the Residence Office by no later than the 14th

October 2011

2. Late applications will NOT be considered. Applications can only be dropped off in the Drop Off Box in the RESIDENCE 4 OFFICE.

3. Proof of payment of R2500.00, must accompany the application form IF YOU HAVE NOT CLAIMED YOUR SECURITY DEPOSIT (R1500) AT END OF SEMESTER 2

2011 or else the Residence Deposit R4000 applies for your application to be processed. 4. Residence Deposit: includes the R400 admin fees and R1500 Security Deposit and R2100 is credited towards the accommodation fees.

5. The payment of the Security Deposit does not confirm your placement for accommodation, but assures you a place in the waiting list.

6. The Residence Deposit (R4000.00) is NOT REFUNDABLE, should you decide NOT to take up residency offered to you.

7. Inclusive of the above mentioned conditions, accommodation will still only be granted to students who have accepted their offer to study at Monash South

Africa and FULL RESIDENCE FEES must be paid by the 31st

January 2012. 8. The outstanding amount for accommodation will be indicated on the Offer Letter that will be emailed to the address provided by the student.

9. Proof of payments must clearly indicate your Student No. as a reference.

10. Any applications received after 14th

October 2011 will be considered after finalisation of all other applications.

ATTACH

I D

PHOTOS HERE

Page 3: Application Process and Application Form 2012

BANKING DETAILS

� Account Name: Monash University South Africa

� Branch Name : FNB CRESTA CENTRE

� Branch Number : 254905

� Account Number : 62062732485

� REFERENCE NUMBER : PLEASE PROVIDE YOUR MONASH STUDENT NUMBER

The information on this form is collected for the primary purpose of registering for accommodation. If you chose not to complete all questions on this form it may not be

possible for Monash South Africa to assist you with your request. Personal information may also be disclosed to Monash South Africa and its controlled entities. You have a

right to access personal information that Monash South Africa holds about you, subject to any exceptions in relevant legislation. If you wish to seek access to your personal

information, please contact the Student Services Centre on +27 11 950 4000.