AMSU - Housing

Housing

AMSU Accommodation Service Form

Personal details:

Mr / Ms / Mrs:

Mr.
Ms.
Mrs.

Title:

First name:

Last name:

Address:

Postal code:

City:

State:

Country:

Is this address also your billing address?

Yes
No

Email:

Telephone (County Code, Regional Code, Number):

Fax (County Code, Regional Code, Number):

Date of Birth (please use the format DD/MM/YYYY):

Place of Birth:

Nationality:

Passport Number:

Passport Expiration Date (dd/mm/yyyy):

Room specification:

Roomtype:

Shared room in a student apartment house (2 persons) € 38 p.p.p.n.
Single room in a student apartment (shared facilities with max. 4 persons), € 48,- p.p.p.n.

Date of Arrival (DD/MM/YYYY):

Date of Departure (DD/MM/YYYY):

Number of Nights:

Specific Requests:

I have read, understand and agree with the applicable terms and conditions

I would like to stay informed about AMSU courses and activities

The Amsterdam - Maastricht University

Housing