Request form - CityArk Aparthotel CityWest Aparthotel Request form Personal information Full Name ( First and Second Name ) * Phone number * Email Address * Type of Room * Standard Double RoomSuperior Double/Twin Room Ideal moving in date * Are you fully employed * Yes No Are you beneficiary of the House Assistance Payment Scheme ( HAP ) * Yes No *If yes, please note that the building does not have a fully equipped kitchen which is one of the requirements for the HAP to be applicable. Will you require a parking space ? * Yes No Would you like to do a video call to see the property ? * Yes, Please contact me to arrange a video call where I can see the rooms, location, etc... Due to Restrictions we are not currently organising physical viewing ! We will give you a call when we have an update Covid-19 Declaration * I hereby declare that I have no symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness or flu like symptoms now or in the past 14 day. Covid-19 Declaration * I hereby declare that I have not been diagnosed with a confirmed or suspected Covid-19 infection in the last 14 days, and that I have not been in close contact with a person who is a confirmed or suspected case of Covid-19 in the past 14 days. Covid-19 Declaration * I hereby declare that I have not been diagnosed with a confirmed or suspected Covid-19 infection in the last 14 days, and that I have not been in close contact with a person who is a confirmed or suspected case of Covid-19 in the past 14 days. Any questions/comments you have You can suggest a different time, tell us about your self, etc... Yes, I want to receive emails about new services, offers, and promotion related to City West Aparthotel and City Break Apartments Group. I can withdraw my consent at any time If you are human, leave this field blank. Submit CONTACT DETAILS USEFUL LINKS OTHER PAGES OUR NEWSLETTER Name Please enter your name. Email Address Please enter a valid email address. Subscribe! Thanks for subscribing! Please check your email for further instructions. Something went wrong. Please check your entries and try again.