CARRYCORD PTY. LIMITED ABN 86 054 141 329

 ...........Print this form in PDF.........Print this form in MS Word

P.O. BOX 250 ST. PAULS. N.S.W. 2031 AUSTRALIA.............info@carrycord .com

TELEPHONE (612) 9398 5103   MOBILE 0416 219 627   FAX (612) 89151741

Accommodation Application Form

Your email address

Your name Your home address

Your telephone #Mobile telephone #Fax #

Your date of birth : Day01020304050607080910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear19951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940MaleFemale

Nationality Passport #

Accommodation start date.Day01020304050607080910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20082009201020112012..Accommodation.finish date.Day01020304050607080910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20082009201020112012

Airport reception required?NO YES ..We need your flight details even if you do not require airport reception this can be advised later.

Flight arrival date ...Flight arrival code & number ...Flight arrival time

Do you smoke? NO YES ...Will you allow smoking in the house?YESNO

Do you have any illness or special dietary requirements?

Are you allergic to animals?NOYES...What are your interests?

Other comments 

The name & address of your school in Sydney 

Course start ...Day01020304050607080910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20082009201020112012.........Course finish...Day 01020304050607080910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20082009201020112012

It is the students responsibility to ensure they possess proper and valid travel documents.

Cancellation fees: Arrangement and Airport reception fees are not refundable or transferable.

• If the student cancels prior to 30 days of arrival date, full refund of accommodation less bank charges.
• If the student cancels between 15 and 30 days of arrival date, a fee equivalent to one weeks rent will be charged.
• If the student cancels within 14 days of arrival date, a fee equivalent to two weeks rent will be charged.
• If the student cancels on or after the arranged accommodation start date, no refund will be given except in exceptional circumstances.
• The student is expected to stay the first four weeks.

Invoice Payment 

Please deposit to our bank account with Westpac Bank 49-51 Belmore Road, Randwick, 2031

BSB No. 732 - 056 Swift # WPACAU2S Account Name is Carrycord Pty. Limited. Account No. 66-1880

Or please charge the full amount to my Credit Card: VisaMastercard

Credit Card numberExpiry Month 010203040506070809101112Year2008200920102011201220132014201520162017The last three digits of the number on the back of the credit card 

Homestay Invoice A$1385  includes airport reception * or  Homestay Invoice A$1253 airport reception NOT included.

Homeshare Invoice A$1105 includes airport reception * or  Homeshare Invoice A$973 airport reception NOT included.
Print Name that is on the card