Housing Contract 2008-09

"

Housing Contract 2008-09
Items in bold are required.
Last Name
First Name
Middle Initial
Home Address
City
State
Zip
Home Phone
Cell Phone
UC Email Address
Alternate Email Address
Date of Birth
Age
Gender
Status



Hours Completed after Spring 2008



Major
Athletic Team(s)
Meal Plan Option




First-year students may only select 1, 2, or 3. Upperclassmen may select 1, 2, 3, or 4. Only apartment dwellers may select from all 6.
Rank your preference for room type. Use a 1 for first choice, 2 for second, and 3 for third. First-year students are limited to the first two choices.
Brotherton Hall Double
Middle Hall Double
Middle Hall Suite
Middle Hall Apartment
New Hall Double
New Hall Apartment
Cox Hall Single
Cox Hall Double
I need ADA accommodations
Please contact Director of Residence Life to discuss ADA accomodations
Double Roommate
Apartment/Suite Roommates Apartment and Suite Information: Only groups of four upperclassmen may apply for an apartment or suite. Each member of the group must have at least a 2.85 GPA for the group to eligible. Apartment and suite assignments will be determined by a formula that considers academic class, GPA, judicial standing, and community involvement. Please list one roommate under “Double Roommate” with whom you would like to live in the event that you do not receive an apartment or suite.
I am a member of (team, organization, group) For apartment/suite applicants only.
Number of occasions in violation of UC Student Expectations For apartment/suite applicants only.
Cumulative GPA For apartment/suite applicants only.
All residential students are required to have health insurance while residing on campus. If you are in need of health insurance, please contact the Office of Student Life for information on available plans.
Emergency Contact
Contact Relationship
Contact Primary Phone
Contact Secondary Phone
Health Insurance Company
Policy Number
Group Number
Health Insurance Company Phone
Primary Care Physician
Physician Phone Number
List any medical conditions, allergies, and/or medications that the University should be aware of in case of emergency (if none exist, type none)
Conditions
Roommate Preference

I'd prefer a roommate who is:







I'd prefer a roommate who likes:







My music preferences:







I agree that checking this box and completing a housing application constitutes an agreement to comply with the terms and conditions of the 2007-2008 Housing Contract and the policies and procedures of the University of Charleston. If under the age of 18, a parent or guardian is required to review the 2007-2008 Housing Contract and to check this box, constituting an agreement to comply with the terms and conditions found herein.
I agree to all policies
If you are not taken to a page indicating your application has been received within 10 seconds, then you have not filled in all required fields. Please check your entries and then submit.
If you are a NEW student, please send payment for your $100 deposit to:
University of Charleston Student Solutions Center
2300 MacCorkle Avenue SE
Charleston, WV 25304
Returning students do not need to submit a deposit.