Name
Date of Birth
Phone
Email
Address
Academic Institution
Qualification
Year of Study (when in Res)
Student Number
Religous Affiliation
Are you a member of the ACTS branch on your campus?
What Chaplaincy / Parish activities have you been involved in previously?
What chaplaincy activities will you be or hope to be involved in whilst in residence?
Extra-curricular activities
Have you been in another residence?
Why have you decided to move from that residence?
Have you Been Vaccinated for Covid-19
List any importance illnesses you are or may be suffering from
Your doctor’s details
Emergency Contact
How are your fees being paid"
If you under a bussary please provide details
If not on a Bussary please fill in details of the person reponsible
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