CONFIDENTIAL

Division of Student Administration – LASALLE Residences

AY2017/18 Accommodation Application Form

St Patrickʼs House, 498 East Coast Road Singapore 429102

Name & Stamp of Agent (if any):

Personal Information of Student Resident:

Full name (as in passport):
(Underline last name)

LASALLE Student ID FIN number (if available): Email address:

(if available):

Nationality: Gender: Male / Female Age:

Mailing address (Your housing contract & agreement will be sent Home country contact (to include
to this address): country & area code):

Singapore contact (if any):

In case of emergency, please contact:

Name of next of kin: Relationship: Home country contact:

Name of local guardian: Relationship: Local contact:

st nd
Room Type Preference (please indicate 1 for your 1 choice, 2 for your 2 choice and so on)

Single Room Double Sharing Room Triple Sharing Room

Single Suite Room Double Sharing Suite Apartment

(Single / Double Occupancy)

Name of roommate (if any): ___________________________________________ (For Double / Triple Sharing)

Your roommate must submit a separate hostel application form. Has he/she done so? YES / NO

*Room assignment / Room change is at the sole discretion of LASALLE College of the Arts.
Period of Stay (please tick one):
1 Academic Year Semester 1 Semester 2
24 July ‘17 – 23 May ‘18 24 July ‘17 – 22 Dec ‘17 2 Jan ‘18 – 23 May ‘18

Floor Preference (please tick one):

Girls Floor Only Co-ed (Mixed) No Preference

If you cannot get a bed in your preferred room type or floor type, would you be open to consider a bed in a
different room type or floor? YES / NO
Medical conditions, Special Needs or Disabilities:
LASALLE is fully committed to equal opportunity for all students. It is important if you do have any medical condition, special
needs or physical disability, that you let us know and we will do our best to make every reasonable effort to accommodate you.

Terms and conditions apply.

I declare that all the information provided by me is complete, accurate and true.
All information provided will be kept confidential and will only be used for its intended purpose.

Applicant Signature: _________________________ Date: _________________

Parent’s Signature: _________________________ (for applicants below 18 years of age) Date: __________________

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CONFIDENTIAL
Division of Student Administration – LASALLE Residences

AY2017/18 Accommodation Application Form

Room Types & Rates for Academic Year 2017/18
Rates specified are per person per month. An additional 7% Goods & Services Tax (GST) charge is applicable.
Payment is by semester basis.

Room Type # Room Rate Per Person Per Month # Room Rate Per Person Per Month
Fully Air-Con with Common Bathroom (One Semester) (One Academic Year)
Single Room SGD940 SGD750
Single Suite Room SGD1375 SGD1100
Double Sharing Room SGD750 SGD600
Double Sharing Suite with attached bathroom SGD1100 SGD880
Triple Sharing Room SGD580 SGD420
SGD2200 SGD1980
1 Bedroom Apartment with attached bathroom * (Single Occupancy) (Single Occupancy)
* Double occupancy rate is available.
Kindly check with LASALLE for the room rates
Application Fee (non-refundable) SGD60.00 (per application)

Application Procedure
1. Submit the completed application form (overleaf) to:
Division of Student Administration – Student Services (DSA-SS)
LASALLE College of the Arts
1 McNally Street, Singapore 187940
2. The application deadline is by 30 April 2017.
3. You will be informed of the outcome of your application within four weeks after the application deadline, with the condition that you
have registered with the college, paid the school fees and are in the process of applying for your student pass.
4. Application fee (SGD60.00) must be submitted together with this application form, via the following modes:
Payment Modes Remarks
Cash • Prepare exact amount for payment over Finance counter (counter closes at 2.45pm)
Cheques/ Bank Draft/ Cashier’s • Made payable to LASALLE in Singapore Dollars (S$)
Order • Indicate student’s full name, passport number and Applicant ID behind the cheque
Visa/ Master/ CUP Credit Card • Payment over Finance counter (counter closes at 2.45pm)
NETS • $2000 per card per day (Standard Singapore bank limit)
Telegraphic Transfer • Bank Account Name: LASALLE College of the Arts Limited
• Bank Account Number: 004-016762-7
• Swift Code: DBSSSGSG
• Bank Code: 7171
• Branch Code: 004
• Bank Name: DBS Bank
• Branch: Parkway Parade Branch
• Address: 80 Marine Parade Road, #01-12 Parkway Parade, Singapore 449269

• All bank charges must be borne by students

• Indicate student’s full name and Applicant ID
• Email to studentservices@lasalle.edu.sg with a copy of the TT remittance advice, student’s name and
applicant ID once payment is made

5. Incomplete application form and/or submission of form without application fee will not be processed.
6. Submission of this application does not guarantee an offer of accommodation. Rooms will be allocated on a first-come first-
serve basis.
7. The minimum lease period is ONE semester (5 months).

Confirmation Procedure
To confirm your place at LASALLE Residences, you must return the following to DSA-SS:
1. A signed Accommodation Contract Offer
2. A signed Accommodation Agreement
3. Payment of your first month’s rent (strictly non-refundable), AND
4. Payment of security deposit (equivalent to 2-months rental). Once checked in, the security deposit will be forfeited should the
student not fulfill the full lease term.

Other Information
1. AY2017/18 rental rates are subject to change and will be confirmed at point of offer.
2. LASALLE reserves the right to review the rental rates periodically to align with industry practices and economic changes.
3. Residents may apply to stay during the vacation/semester break at an extra charge and subject to room availability.

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