Housing Request Form 2019 Italian Language Program

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GENERAL HOUSING INFORMATION: LdM offers a free service to help students find accommodations for all campuses. Students are not obliged to choose housing through LdM if they wish to find their own accommodations instead. HOUSING OPTIONS 2019: 1. All apartments and rooms in home stays are NON-SMOKING. 2. For a short stay (e.g. a week) LdM recommends that students reserve a room at a local hotel. We will provide a hotel list upon request. 3. The standard period for a shared apartment is one month, if available we can book apartments for 2 or 3 weeks. 4. For those who would like more privacy and independence, LdM can provide a list of recommended agencies through which it is possible to find independently a small, furnished apartment to accommodate up to two people. 5. Double rooms are subject to availability and are only offered to students who know each other prior to arrival at LdM. Applicants are requested to specify their preferred roommate on their housing form. Double room prices are available upon request. 6. In order to secure a spot in one of our accommodations it is highly recommended to apply indicatively not later than one month before arrival. In general, the later you apply the harder it is to satisfy your request. In the case we are not able to meet your request, we will introduce you to other possible options. 7. LdM reserves the right to change the assigned accommodation at any time prior to the student s arrival. 8. LdM reserves the student s accommodation from 1 day earlier the course starts to 1 day after the course ends RESERVATION PROCEDURE: The following are required for LdM to begin to process the initial housing request: Housing Request Form completed and signed Proof of Payment of Housing Security Deposit Euro 150 at the time of application Two Copies of your passport (photo page) The following are required a week before the student arrival date: Two Copies of your visa (on your passport) if requested Detailed travel Itinerary 1. The student must e-mail all of the required documentation to LdM - Housing Coordinators Office E-mail: housing@lorenzodemedici.it or by mail to Via Faenza, 43, 50123 Florence, Italy Tel. +39 055 28 73 60 / +39 055 28 72 03 Fax + 39 055 23 98 920. 2. LdM will proceed to arrange housing for the student after having received the proof of Housing Security Deposit payment. 3. About a week before the Check-in date, LdM will provide the student with (via e-mail): a. type and address of the accommodations. b. information about Housing Check-in

PAYMENT REGULATIONS: 1. Within two days from your arrival you need to pay the rent fee directly to your landlord in cash. 2. Utilities (gas, electricity, water) are included in the cost. 3. Students are responsible for paying damages to the accommodations caused by their negligence. 4. Security Deposit - For all options a security deposit of 150 is due upon application. This serves as guarantee for the reservation of the accommodation (the proof of this Housing payment has to be included with the students Housing request form at the time of application. If there is no damage to the apartment and its contents the 150 security deposit will be totally refunded to the student on the last day of classes. The security deposit may not be used as part of the month's rent. PAYMENT METHOD: Housing Deposit - Choose one of the following methods, always specifying payment in Euro, Student Name, and Housing Deposit as reason for payment : Secure on-line payment (VISA, MASTERCARD, AMERICAN EXPRESS, JCB) at: http://pay.ldminstitute.com All credit card transactions are subject to a 2% convenience fee at the time of payment. Bank cashier s check or international money order payable to Lorenzo de Medici s.r.l. to be sent to: Istituto Lorenzo de Medici Attn: Housing Coordinators Office Via Faenza, 43 50123 Firenze - Italia Bank transfer to the following bank account (please provide the LdM Housing Office a copy of the bank receipt as proof of payment): Name: Lorenzo de Medici Account #: 85450 Bank: Cassa di Risparmio di Firenze Sede Address: Via Bufalini, Firenze ITALY ABI code: 06160 CAB code: 02800 SWIFT code: CRFI IT 3F IBAN code: IT70U0616002800000085450C00 All bank charges shall be paid by the student. Housing Rent - To be paid directly to your landlord in cash within two days of arrival. CANCELLATION POLICY: If an official cancellation notice is received by LdM: 31 days or MORE before the check-in date, the housing deposit will be refunded. 30-0 days before the check-in date, the student will lose the housing deposit After arrival, if for any reason a student decides to leave her/his accommodations before the end of the pre-agreed rental period, she/he must give the owner and LdM 2 (two) weeks notice; otherwise the housing deposit will not be refunded. The student will be fully liable for the total housing deposit if no official notice of the student s cancellation is received by LdM before the check-in date. Students will receive the refund minus the cost of any transfer fees

PERSONAL INFORMATION Last Name Date of Birth (dd/mm/yy) First Language Passport issued by City/State of Birth Permanent Home First Name Female Male Country of Citizenship Passport Number Passport Date of Issue Country of Birth Address City Postal Code Country EMERGENCY CONTACT Name Phone / Mobile Relationship Email HOUSING OPTIONS & COSTS 2019 Check the desired Type of Accommodations and the LdM Location where you will be studying: HOME STAY Single Room Bed/ Breakfast (only breakfast included) Half Board (breakfast and dinner included) Price Campus from 27 to 35 per day Florence Tuscania Rome from 37 to 45 per day Florence Tuscania Rome SHARED APARTMENT Single Room Single Room for stays less than 1 month Price Campus from 500 to 900 per month Florence Tuscania Rome Prices will be given upon request Florence Tuscania Rome Double room: this option is subject to availability and is only offered to students who know each other prior to arrival at LdM. Double room prices are available upon request. If you are interested in this option please specify your preferred roommate below: ** Please note all of our apartments are fully furnished with washing machine, kitchen, bathroom, common area and internet connection. OTHER OPTIONS If the housing options listed above don t meet your needs, LdM can provide you with a list of recommended agencies through which it is possible to find independently a different accommodation. Indicate Dates: Check-in Check-out Day Month Year Day Month Year We suggest renting your apartment one day before the classes start and ending one day after the final day of classes.

ALL STUDENTS: PERSONAL PROFILE Age: Gender: Do you have any special conditions or needs that you would like the housing coordinator to be aware of? (anxiety disorder, depression, learning disability, eating disorder, physical limitation; religious belief, ect. Allergies (if any) AND/ OR Other health problems that need to be taken into consideration: THE FOLLOWING QUESTIONNAIRE IS ONLY TO BE FILLED OUT BY STUDENTS SELECTING THE HOMESTAY OPTION: NOTE: The LdM Housing Office will consider the preferences/requests communicated on the Personal Profile and will make every effort to find the most compatible placement. However, the LdM Housing Office cannot guarantee that all preferences/requests will be accommodated. Please be advised that the Cancellation Policy will apply in the case of all cancellations, regardless of reason. My family members / I membri della mia famiglia Name / Nome Relationship / Relazione Relationship / Relazione 1. 1. 2. 2. 3. 3. 4. 4. Why are you choosing to live with a host family? Hobbies/Interests: List specific foods that you do not eat (meat, fish, vegetable, etc.). Please select the box which most closely describes you and/or your living habits: Please specify the following: o Smoking I play sports: My ideal night out with friends is: o Non-smoking o Regularly o Going out to dinner o Vegetarian o Sometimes o Cooking a meal at home o Non-vegetarian o Never and/or watching a movie o Dancing I would describe myself as: When getting ready, I usually take: o Extroverted o 15 minutes or less I like to go out at night with friends: o Somewhere in between o 15 minutes to hour o All the week o Introverted o More than an hour o Weekends only o I usually do not go out at night Sleeping habits: I like to go to places: o Early riser everyday o I enjoy walking every day Do you plan to travel a lot when you are o Late riser everyday o I enjoy walking occasionally studying in Italy? o Early to bed during week and late to o I don t like walking o Yes, I plan to travel all over Europe bed on weekends o Somewhat, I plan to travel mostly Would it be an issue for you to live within Italy in a family with pets? o Not much, studying abroad is my travel o Yes, because I have allergies o Yes, I would prefer a family without pets o No, pets are not a problem for me If there is something else you want us to know about yourself, please write it down in few lines.

I appoint the Lorenzo de Medici Institute to forward, in my name and on my behalf, my payment of the housing deposit and expenses as established and chosen in this application form. I understand that: I will enter my apartment ONLY at the Check-in date, and I must leave the assigned apartment no later than 12:00 noon on Check-out day; In case of damages to the apartment, and/or the apartment left in an unclean, or otherwise unacceptable condition, the cost will be withheld from the deposit; LdM reserves the right to expel from the assigned apartment any student whose behavior does not conform with civilized standards of behavior; I HAVE READ, UNDERSTOOD, AND WILL ABIDE BY ALL OF THE LORENZO DE MEDICI POLICIES, RULES, AND REGULATIONS ON THIS FORM. PRIVACY POLICY The student, with the signing of the application form, declares to have seen, read and received a copy of this information in English. Furthermore, the student declares to have read and understood this "Privacy Policy", in its entirety, consisting of three pages and gives explicit authorization to Lorenzo de Medici S.r.L for the processing of their personal data. For personal data in accordance with art.4, par.1, lett. a) GDPR refers to: "any information concerning an identified or identifiable natural person (" concerned "), identifying the natural person who can be identified, directly or indirectly, with particular reference to an identifier such as the name, a number of identification, location data, an online identifier or one or more characteristic elements of its physical, physiological, genetic, psychological, economic, cultural or social identity". I allow LdM exclusively to collect, publish and use for purposes of advertising and promotion that are not detrimental to my dignity or reputation: 1) my image in photographic, video or digital content; 2) my own writings, figurative works, music, art and creative projects; 3) my name in conjunction with interviews and statements in relation to LdM. I permanently waive all rights of compensation for the aforementioned content generated in the period of enrollment at LdM, which may be reproduced either in its entirety or in part, in the form of any multimedia content, and may be published on the following website, www.ldminstitute.com, and/or in other domains related to LdM in Italy and abroad.