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Summer Housing Request

  • Required fields are marked with an asterisk.* 

    First Name*

    Last Name*

    Capital ID Number*

    Contact Phone Number*

    Email*

    Current Residence Hall Building and Room

    Gender


    Smoker 

     

    Roommate Request 1

    Roommate Request 2

    Roommate Request 3

    Living on Campus 2015-2016? 

            

    Will you remain in your current housing assignment until your Summer Housing assignment is available? (Please note, residents will be charged for this time period)
     
            

     

    Desired move-in date.
     [None] Select a Date Delete the Date

    Desired move-out date
     [None] Select a Date Delete the Date

    Reason for Application: 


    Other Information you want us to know