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2012-2013 Housing Application
  • 2012-2013
    Housing Application

     

    New First Year and Transfer Students

    After you have completed your online housing application, please print, complete, and mail or fax a copy of the Campus Housing Agreement to the Residence Life Office. Once we receive your on-line housing application and your completed copy of the Campus Housing Agreement (PDF), you will receive a confirmation letter via the email address you have provided.

     

    Continuing Capital University Students

    Students will complete the Campus Housing Agreement during the room selection/lottery process each Spring. Those returning students who do not participate in the room selection/lottery process should print, complete and mail or fax a copy of the Campus Housing Agreement (PDF) to the Residence Life Office.

    Students will not be assigned to campus housing until the completed Campus Housing Agreement is received.

     

    Required fields are marked with an asterisk.* 

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    First Name*
     
    Middle Name
     
    Last Name*
     
    Nickname
     
    Gender
     

     
    Birthday
     [None] Select a Date Delete the Date 

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    Permanent Home Address
     
    Permanent City
     
    Permanent State
     
    Permanent Zip
     
       
    International Address
     

    Home Phone
     

    Cell Phone
     
     
    Email
     
    Capital University ID Number
     
     

     
    Student Status
     
    Class Level
     
     
    Intended Major
     
    Enrollment Term*

     
     
    Ethnic Background

     
    International Student?
                   
     
    Recruited Athlete?
                   
       
    If Yes what Sport:
     
       

    Emergency Contacts

     

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    Emergency Contact Name
     
    Emergency Contact Phone
     
    Emergency Contact Relationship

     

     

    Please provide a confidential contact person to be notified within 24-hours of a determination that the student is missing as established by campus safety or local law enforcement. If the student is under the age of 18, the students parent/guardian will be notified.

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    Missing Person Contact Name
     
    Missing Person Contact Phone
     
    Missing Person Contact Relationship
     

    General Information 

    General Information
    Smoker - I am a:
                   

    Note that all residence halls are non-smoking.  

    Sleep Habits - I go to sleep:
                   
       
    Study Habits:
                                                         
    Neat / Messy - I like to live in a room that is:
                   
       
    Guest Preference - In my room I like to have:
                   
     


     
    Do you have a roommate preference?
    (requests must be mutual)
                   
    If Yes, name up to 5 potential roommates
     
       
    Single Room Request?
                   
    Special Needs?
                   

    Additional Information

    Cluster Housing
    Cluster Housing Selection  (New First Year Students Only):
     

     

    Honors Cluster - Students living in the Honors Cluster will participate in gatherings, seminars and cultural enrichment in collaboration with the Honors Program. The Honors Cluster is open to students who apply and are accepted into the Honors Program.

     

    Academic Cluster - Students living in an Academic Cluster will be housed on a floor with other students in their intended academic area of study and will receive targeted programming from their academic area.

     

    Healthy Choices Cluster - Students living in the Healthy Choices Cluster will receive targeted programming on academic, personal, and interpersonal wellness topics. They will sign a contract committing to live substance (alcohol, tobacco, and other drugs) free. Please note, the Healthy Choices floor will be co-ed and house both first year and upperclass students.

     


    Is there any other information that Residence Life & Housing needs to know in order to process your application:


    Please only press Submit once. Processing may take a moment.   

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