PERSONAL INFORMATION PLEASE USE BLOCK LETTERS
PLEASE COMPLETE THE APPLICATION AND EMAIL TO resmanager@trinityjhb.co.za
REFERENCES AND OTHER REQUIRED DOCUMENTS MAY BE SENT LATER.
Accommodation required for what year: _____________________
2023 etc
Name in full: Surname : ___________________________________________
First names ____________________________________________
Date of birth ___/___/_________ (DD/MM/YYYY)
Academic Institution Studying at: ______________________ (e.g. WITS, UJ,)
Degree/diploma applied for: ______________________ (e.g. BA, BSc, HDE)
Academic year when in Res: ______________________ (e.g. 1st, 2nd, 3rd, 4th, Honors)
Student number ______________________
Home address _____________________________________________________
_____________________________________________________________________________
Home telephone number: ________________________Cell No.: _______________________
Contact tel.no:.______________________ (We will phone here to arrange an interview)
Email address_______________________________________@________________________
Religious affiliation: ___________________________ (Catholic, Anglican, Baptist, No Affiliation etc)
Are you a member of the ACTS branch on your campus? (+ 2nd yr.) _____________
If NO – What chaplaincy / parish activities have you been involved in previously? Please mark with x
Monday Soup kitchen: , Wednesday Soup kitchen: , Come Home Bible: ,
Lunch Soup kitchen: , Hospital visit:
Other: __________________________________________________________________________
What chaplaincy activities will you be or hope to be involved in whilst in residence? Please mark with x
Other:___________________________________________________________________________
Extra-curricular activities: School Prefect:: , Alter Server: , Soccer :, Netball:
Volleyball: , Captain: ,
Other: ___________________________________________________________________________
Have you been in another residence? Yes No
Which one? ___________________________________________
Why have you decided to move from that residence?
___________________________________________________________________________
List any importance illnesses/allergies you are or may be suffering from: –
Your doctor’s telephone number: ______________________
Have you been Covid-19 Vaccinated: ___________________
Dietary requirements: No dietary restriction: . Vegetarian: Vegan:
PAYMENT DETAILS How are your fees to be paid? ___________________________________________________
Give details of any bursary or scholarship which you will have for residence. Include the name,
address and telephone number of the person or organisation supplying the bursary or scholarship. ___________________________________________________________________________
___________________________________________________________________________ If no bursary is available to you please give the name and details of the person responsible for
paying your fees below: A letter of guarantee from the person responsible for your fees is also
required to accompany this application. Credit checks will also be carried out on the person
responsible for the account.
Name: __________________________________ ID Number: _________________________
Relationship (e.g.. father, mother, uncle etc.): _________________________________________
Physical Address: ______________________________________________________________
Contact Number 1) ____________________ Contact Number: 2) ______________________
Email Address: _______________________________________________________________
Do you intend to bring a car to Trinity House? Yes No
Details of your parents or guardian (in case of emergency while resident at Trinity House):
Name _____________________________________________________________
Address _ ____________________________________________________________
Contact number: _____________________
Email Address: ______________________________________________________________
Please include the following:
1) A written reference from your Parish Priest
2) A written reference from your last High School (1st year students)
3) A written reference from a person who knows you well
4) A letter (of at least one A4 page in length) stating why you want to stay in Trinity House (include a short
history of yourself, how you have been involved in your community)
Signed: _________________________________________ Date: _________________________
PLEASE EMAIL THIS COMPLETED FORM, TOGETHER WITH YOUR MOTIVATION LETTER AND OUT-REACH REPORT TO: resmanager@trinityjhb.co.za
YOUR PROOF OF PAYMENT FOR YOUR REGISTRATION/ADMINISTRATION FEE MAY BE EMAILED TO resmanager@trinityjhb.co.za
FOR YOUR ATTENTION:
Space at Trinity is limited so we strongly recommend that you apply to other
residences as well, just in case you cannot be offered a place in Trinity House.
Trinity House Catholic Chaplaincy & Residence
Nedbank Braamfontein, account number 1965338593; Branch code 196505.
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