ELSMA-REZ ONLINE APPLICATION
 

Please complete all fields below. All fields with * are mandatory. If the question is not applicable then just fill in NA

  * Fields are mandatory
  * Accommodation Type Applied For: (tick relevant type/s on the dropdown list)
     
 
   
  * Title
     
 
   
  * Gender
     
 
   
  * Applicant please complete the fields below
     
  Name and Surname
  Email Address
  Cell Number
  International Code(+27)
     
  Date of Birth --
   
  * Duration of Stay : Months (min 10 months)
 
   
  Applicant Country of Origin
   
  * Current Residential Address
 
   
  * Sponsoring Details If Not Applicable Just Fill In NA
     
  Who is your sponsor?
  What is your sponsor/bursary email address?
  What is your sponsor/bursary Contact No: Cell or Tel?
  What is your monthly income?
     
  * University Information (applicable to students only)
     
 
   
  * If Selected Other on above give us precise description.
 
   
  * Year of Study
     
 
   
  * If Selected Other on above give us precise description.
 
   
  * Area of Study
     
 
   
  * If Selected Other on above give us precise description.
 
   
  * Tell Us More About You
     
  What is your home language?
  What is your home address?
  Who should be contacted in case of emergency Name and Contact No?
  Where did you hear about Elsma-Rez?
  If you where referred to the Elsma-Rez by a student provide their name and contact details.
  Will any of your Friends be living at Elsma-Rez?
     
  * Have you rented a property in South Africa during the previous year?
     
 
   
  * If Yes on above please give details of Agent/Landlord
 
   
  * Declarations (tick boxes)
     
  I declare that the information above is true and correct (NB: Credit and criminal check will be conducted on prospective tenants)
  I consent to the Landlord or Agent to Contact, request and obtain information from any credit provider or registered Credit Bureau relevant to an assessment of the behavior, profile, payment patterns, indebtedness, whereabouts and credit worthiness of myself
  I consent to the Landlord or Agent to furnish information concerning the behavior, profile payment patterns, indebtedness whereabouts and credit worthiness of myself to any registered credit bureau or to any credit provider seeking a trade reference regarding my dealing with the Landlord or Agent.
     
  Please enter date --
   
   
 

PLEASE NOTE THESE FILES ARES LIMITED TO 1MB ideal jpg size 680pixels by 480pixels. AND CAN ONLY BE THE FILE TYPES: jpg  jpeg pdf

   
  * Identity Document (chose & upload): SA-ID Or Passport