Wrexham Student Rooms

Reservation Request

Please fill out the following form; if your first or second choice are unavailable, we will contact you to discuss alternatives. Please note that the room/s will not be reserved until a booking deposit payment of (£180) has been received and acknowledged.

Please DO NOT select a Room which is not showing as being available for the period that you require it.

Your Details:

*Title:		other
*Family Name:
*First Name:
*Date of Birth:

Permanant Address:

*House Number:
*Address Line 1:
Address Line 2:
*City:
Post Code:
*Country:

*E-Mail address:
*Enter E-Mail again:
Home Telephone Number:
Mobile Telephone Number:

* - Required Fields

I would like to reserve the following room/s:

		Starting Date	Leaving Date
First Choice: *
Second Choice: *
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