Kopie van Formulier: Contact Form Students - thuisbijantares.nl

Contact Form Students

Contact details
Please fill out all the required fields, so we can register you correctly.
Given name (first name)*
Family name (last name)*
Gender:*
- Male
- Female
- Gender neutral
Date of birth*
Home address*
Zipcode & city/town of your home address*
Nationality*
Country you live in*
Phone number*
E-mail address*
Contact details in case of emergency
Please fill out who we can contact in case of any emergency.
Relationship to tenant*
Given name (first name)*
Family name (last name)*
Phone number*
E-mail address*
Home address*
Zipcode & city/town*
Country*
Details for checkout & deposit
In order to repay your deposit, we need some additional details. If there are any changes in these details, please let us know as soon as possible as we can make sure the deposit will be refunded correctly.
Name of the account holder*
IBAN or bank account number*
BIC or SWIFT of the bank*
Name of the bank*
Bank code*
Address of the bank*
Zipcode & city/town of the bank*
Country of the bank*
Additional information (not obligatory)
Payment*
You can either pay your rent monthly, in two amounts or all at once. We want to notice you that every time you make a payment, there will be additional transaction costs. Therefore it is more efficient to pay in one or two amounts.
- Monthly payment
- Payment in two amounts
- Payment in one amount
Agreement
I agree that my contact details will be shared with my future roommate(s) for the purpose of handing over the key. Antares will not share your contact details with any other people or organizations without your explicit permission.
Thank you for filling out this form! If there are any questions, please contact us: student@thuisbijantares.nl.
CAPTCHA