ACCOMMODATION FORM

Fill in the form, sign it and send it back to the International Relations Office of Ca’ Foscari University of Venice as soon as possibleby e-mail () and in paper copy along with the rest or required documents. You request will be forward to the person in charge of the Housing Office and you will be contacted directly with availability and further details.

STUDENT’S PERSONAL DATA

PHOTO

Surname (as in ID/passport) ______

Name (as in ID/passport) ______

Place of birth ______Nationality ______

Date of birth (dd/mm/yyyy) ______Gender  M F

Permanent address ______Current address (if different) ______

______

______

______

Main contacts

Telephone number (land)______Telephone number (mobile)______

Fax ______

Email ______

YOUR STAY IN VENICE

Academic year: 20_____/ 20_____

Duration of stay  Full academic year First semester only Second semester only

Expected date of arrival in Venice (dd/mm/yyyy)______

Expected date of departure from Venice (dd/mm/yyyy)______

Home Institution:______

Please note that your request can only cover up to the last week of relevant exam session.

ACCOMMODATION PREFERENCES

Please indicate your choice of accommodation by numbering boxes 1, 2, 3, 4 etc in order of preference

university residence religious institute private shared flat

no preference

Do you want to share a room (single beds)? Yes No

Would you like to share a room if no single rooms are available?  Yes No

Please indicate (one choice only) the most important feature that your accommodation should have:

 single room

 en suite bathroom

 self-catered house

 wi – fi

 shared flat

washing machine

 Other ______

______

SPECIAL REQUIREMENTS

If you have any special requirements (special needs, allergies…) please ensure that we are aware of this.

______

______

______

______

______

TERMS AND CONDITIONS

  • Please note that available accommodation is assigned on a “first come first served basis”.
  • All accommodation is available to the limit of supply

DECLARATION

I understand and accept that Ca’ Foscari University of Venice cannot guarantee any living requests, including roommates or type of accommodation.

I understand and accept the above mentioned conditions of the Service.

Date (dd/mm/yyyy): ______

Signature: ______

Information required by Italian law Dlgs 196/03 – Code on personal data protection

Your personal data will be treated by Ca’ Foscari Housing Office in different formats (on paper or digital format) and will be transferred electronically for administrative purposes.

Exclusively for the above mentioned purposes, your data could be communicated to other organizations which cooperate with Ca’ Foscari Housing Office. Your data will not be further widely divulged for any other reason.

In order to access, modify, update or to deny the use or deletion of your data (ex. Art. 7 of the Dlgs 196/03), you can ask to the organization in charge of data handling: Housing Office Ca’ Foscari, Dorsoduro 3246, Venezia, tel 041 2348200.

Do you agree with the above conditions?

YES □ NO □

By signing the present form, do you also agree to receive future communications and promotions of similar initiatives, also via email to the address provided?

YES □ NO □

Date ______

Signature ______