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RESIDENCE STUDENT FORM
Form Introductory Text
Your Information
Student Information
First Name
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Last Name
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Contact Number
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Email
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Gender
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Male
Female
Religion
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Birthday
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Dietary Information
Type Of Meal Plan
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Type Of Diet
*
Do You Have An Allergy
*
Other Information
Preferred In-House Language
*
Are you a smoker?
*
You are into cultural exchange?
*
Are you okay living with home pets?
*
Preferred staying solo or in a group?
*
Preferred a Bedroom with own Bathroom?
*
Preferred Length of Stay?
*
Name of the School
*
Address of the School
*
INCASE OF EMERGENCY:
Family Member's Name
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Relationship
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Contact Number
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YOUR SIGNATURE
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