Broome accommodation application form

Personal details

Date of birth *
 

Emergency contact details

University details

Are you registered with Majarlin? *
Please note: Due to the high demand for accommodation, Majarlin students can only arrive on the Sunday before their placement start date. Students registered with Majarlin are also kindly requested to check out on the first Saturday after their final day of placement.

Placement details (Majarlin students only)

Placement start date
Placement finish date

Accommodation details

Arrival date
ETA to Broome
Airport pickup
Departure date

Other considerations

Please detail any other relevant information

Photo identification

Please upload a scan/copy of your photo identification *
 
 

After receiving this application form, the Accommodation Coordinator will contact you via email to inform you whether your application has been successful.

The information provided in this form will only be used for the administrative or educational purposes of the University, or in accordance with your specific consent. The University will not disclose your personal information to a third party unless required to or permitted by law or where you have consented to the disclosure. Information relating to how the University collects, uses or discloses your personal information and how you may complain about the University’s handling of your personal information is contained in the University’s Privacy Policy.
You have a right to access your personal information that the University holds about you and to seek its correction. If you wish to access your personal information or inquire about the handling of your personal information, please contact the relevant Campus Registrar via email: fremantle.registrar@nd.edu.au (for Broome / Fremantle Students), or sydney.registrar@nd.edu.au (for Sydney Students)