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application for campus housing

ACADEMIC YEAR

Applicants should understand that by entering into this housing agreement they are liable for the room and board charges for the full academic year (August-May)

 

Academic Year (20xx-20xx)

Please select the semester and/or summer session from the list below.

Fall Semester
Spring Semester
Summer Session I
Summer Session II

Other: Please specify____________________

CLASSIFICATION

1st Year Freshman
Readmit Student
Transfer
Continuing Student
Graduate

NAME


Gender Male | Female

Mailing Address

City

State

Zip Code

Home Phone

Cell Number

EMERGENCY CONTACT

Name

Relationship

Home Telephone

Work Telephone

Cell Number

ROOMMATE/HALL REQUEST

Your Characteristics:

Academic Major/Interest:

Musical Preference - Type:

Music Volume: Loud | Average | Soft

Do you smoke? Yes | No

Previous colleges/universities attended:

Preferred Roommate Characteristics:

  • Morning person
  • Late night person
  • Same major
  • Different major
  • Extremely neat
  • Messy and scattered
  • Other:

Preferred Hall 1st Choice:

2nd Choice:

Alcohol-Free?

Name of Roommate:

Both students must request each other and have applications and deposits submitted. It may not be possible to grant requests received after June 1.

RECEIPT # (required)

A $150 deposit must be on file before a room assignment can be made. You will not be able to submit this online application without a receipt number. Please contact the Housing Office (910.775.4253) to pay by Credit or Debit Card . Please enter the receipt number below.

Receipt #:

Note: You can also mail the $150 deposit (check or money order, there will be a $25 fee chared for returned checks) with a copy of this application to:

UNCP Housing and Residence Life
PO Box 1510
Pembroke, NC 28372

Refund Policy of Room Deposit

The University will refund all except $25 of the room deposit to incoming new students if written cancellation is received by July 31, preceding the fall semester, and by August 8, preceding the spring semester. The room deposit is non-refundable after these deadlines.

SUBMISSION OF FORM

By clicking the Submit button, I (student or Parent/Guardian if student is under 18 years of age) hereby certify that all information presented on this Housing Agreement is true. I have read this document in its entirety and understand the terms thereof.

Updated: Wednesday, May 16, 2012

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© The University of North Carolina at Pembroke
PO Box 1510 Pembroke, NC 28372-1510 • 910.521.6000