New Student Campus Housing Application and Meal Plan Contract

Prior to completing this form, please make sure that you have read and understood the Residence Life Rights and Responsibilities.

First Name: *

Last Name: *

Gender: *

Age: *

High School Name:

Application Term: *

Application Year: *

Home Mailing Street Address 1:

Home Mailing Street Address 2:

City / Town:

State / Province / Region:

Zip / Postal Code:

Country:

Home Phone Number (with area code):

Cell Phone Number (with area code):

E-mail: *

Status: *

Proposed Major:

PLEASE ANSWER QUESTIONS 1 - 4

1. Activities I have been involved with:

2. Co-curricular activities that I plan to pursue in college: *

3. Special needs, physical or medical conditions:

4. Hobbies/Interests:

Housing Preference (first year student):

Housing Preference (transfer/reactivated student):

Roommate Preference: I request to be assigned with:

(To be assigned as roommates, the request must be mutual.)

Meal Plan:

When I study, I: *

In general, I: *

I am: *

Hold down ctrl (pc) and alt (mac) to highlight multiple answers.

I prefer a roommate who is: *

Hold down ctrl (pc) and alt (mac) to highlight multiple answers.

For security, please complete the math question.

Math question: * 5 + 5 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Student Life