JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ON-LINE APPLICATION FORM
By submitting this application, I hereby bind myself to the terms and conditions of the lease agreement applicable to the unit I've chosen.
www.LifeStudent.co.za
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Apartment
*
Choose
2Sharing Apartment (Kitchen+Bath+Study), (Includes Free Wifi, Access Control, PrePaid Token, Back-Up Power and Security
Burchelor Apartment (Kitchen+Bath+Study), (Includes Free Wifi, Access Control, PrePaid Token, Back-Up Power and Security
3Sharing Apartment (Kitchen+Bath+Study), (Includes Free Wifi, Access Control, PrePaid Token, Back-Up Power and Security
4Sharing Apartment (Kitchen+Bath+Study), (Includes Free Wifi, Access Control, PrePaid Token, Back-Up Power and Security
Name
*
Please enter your name.
Your answer
Surname
*
Your answer
Email
*
Enter your email address
Your answer
ID
*
Your answer
Mobile
*
Your answer
Nationality
Your answer
1 next of kin & Contact No
Your answer
2 next of kin & Contact No
Your answer
Car Parking 1 Make and Registration
R350 per parking per month
Your answer
Next
Page 1 of 2
Clear form
Never submit passwords through Google Forms.
This form was created inside of Moloko Group Holding.
Report Abuse
Forms
