Housing Application for Returning Students
Currently Residing Students
Students with Partial Payment
Family Name:
Mailing Address:
City:
Province:
Country:
Postal/Zip:
Phone:
Fax:
Email:
Any Medical Conditions?
Birthdate:
Gender:
Male: Female:
Expiration Date: month January(1) February(2) March(3) April(4) May(5) June(6) July(7) August(8) September(9) October(10) November(11) December(12) year 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
I Certify that I have read and agree to the terms and condition on this application, and wish to apply for accommodations at On-Campus Housing: Agree