Campus Living Application Form
Personal & Contact Information
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Name
First Name
Last Name
Student ID Number
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
Male
Female
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Academic status
Freshman
Sophemore
Junior
Senior
Other
Please select the ones applicable to you
I am an international student
I am an incoming freshman
I am currently student
I am a transfer student
If you have any health conditions, allergies or disabilities, please write here
Please upload a profile photograph, school ID Card photo and any relevant documents
Browse Files
Drag and drop files here
Choose a file
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Emergency Contact Information
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Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Relationship
Mother, father, guardian, relative, etc
Preferences
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Please sort the residence hall list from the most desired to least. If it is not matter, please rank the "does not matter" as the first option.
Do you have any specific person/people in mind to be your roommate?
Yes
No
Please list them
Please sort the list according to importance for you.
Please sort the list according to the most describing your personal characteristics.
Please sort the list according to the most you value your roommate(s) personal characteristics.
Additional Information you want to add?
Submit
Should be Empty: