Reservation Form Pour voir les formulaires de l’Université de Moncton, veuillez activer la fonction Javascript. Formulaire de réservation Personal Informations The field is entered correctly. Please enter your last name. The field is entered correctly. Please enter your first name. Gender * Female Male Please select. The field is entered correctly. The field is required. The field is entered correctly. The field is required. The field is entered correctly. Please enter a valid postal code. Province * Alberta Colombie-Britanique Île-du-Prince-Édouard Manitoba Nouveau-Brunswick Nouvelle-Écosse Nunavut Ontario Québec Saskatchewan Terre-Neuve Territoires du Nord-Ouest Yukon Other The field is entered correctly. Please select. The field is entered correctly. The field is required. Country * Canada United States of America Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antartica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Hercegovina Botswana Brazil British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burma (Myanmar) Burundi Cambodia Cameroon Canary Islands Cabo Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Côte d’Ivoire (Ivory Coast) Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands, The Netherland - Sint Maarten New Caledonia New Zealand Nicaragua Niger Nigeria Niue Northern Marianas North Korea Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Phillipines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent & the Grenadines Saint-Pierre-et-Miquelon Samoa San Marino São Tomé and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tadjikistan Taiwan Tanzania Thailand Timor-Leste (East-Timor) Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Island Tuvalu Uganda Ukraine United Arab Erimates United Kingdom Virgin Islands (USA) Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe The field is entered correctly. Please select. The field is entered correctly. Please enter your phone number. The field is entered correctly. Please enter a valid email address. Information on the stay Arrival Date *: The field is entered correctly. The field is required. Departure Date *: The field is entered correctly. The field is required. Reason for your stay on the campus. Please provide the contact name at the Université de Moncton (if applicable) * The field is entered correctly. The field is required. Name of residence preferred First Choice * Individual Studio Dormitory-style room with shared bathroom and kitchen 2 bedroom studio 3 bedroom studio One bedroom apartment (off campus) 2 bedroom apartment (off campus) The field is entered correctly. Please select. Second Choice Individual Studio Dormitory-style room with shared bathroom and kitchen 2 bedroom studio 3 bedroom studio One bedroom apartment (off campus) 2 bedroom apartment (off campus) Please select. Third Choice Individual Studio Dormitory-style room with shared bathroom and kitchen 2 bedroom studio 3 bedroom studio One bedroom apartment (off campus) 2 bedroom apartment (off campus) Please select. Le champ code de sécurité est obligatoire Le code de sécurité est erroné Submit