Courtyard Student Village

Bru na Gruadan, Castletroy, Limerick

061 332836 / 087 6833790

Summer Application Form

Please fill out the form below in as much detail as possible.

Name*
Mobile No.*
Email*
Home Address*
Date of Birth*
Date Format: MM slash DD slash YYYY
PPS Number
Student ID Number (If applicable)
Occupation*
House type requires*
Number of Occupants*
For Single Occupancy Applicants - Room Type Required
Preferred Check in Date*
Date Format: DD slash MM slash YYYY

Please choose the date you would like to check in - Must be after May 19th 2019
Preferred Check out Date*
Date Format: DD slash MM slash YYYY

Please choose the date you would like to check out. This does not have to be exactly precise but a rough estimation - Must be before August 18th 2019
Nationality*
Emergency Contact Name*
Emergency Contact Number*
Specify House Mates
Any other comments/requirements