Application form to reserve a room or apartment at UniGardens, Canberra

Your name *
Your name
Date of birth *
Date of birth
Gender
Accommodation preferences
I would prefer... *
Do you smoke?
All UniGardens apartments are strictly NO SMOKING, but we can arrange you to share with a smoking flatmate.
Arrival date *
Arrival date
Departure date (if known)
Departure date (if known)
Contact details
If you're sharing with friends, please enter their names and ask them to fill this form separately.