Personal Data |
Last name: |
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First name:
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Nickname: |
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Home address: |
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City: |
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State: |
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Zip:
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Home Phone: |
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Cell Phone: |
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Email address: |
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Birth date: |
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Gender:
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Male
Female
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Parent(s) or Guardian(s): |
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Parent Home Phone:
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(
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Parent Cell Phone:
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(
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Anticipated major: |
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Hall preference
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First preference:
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Second preference:
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Floor preference |
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Select one:
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Freshman Connections Floor
Mixed Class Floor
Quiet Floor
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Room preference
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Select one:
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Double Room
Single Room (not available to incoming freshmen)
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Meal plan |
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Select one: |
Gold (3 meals/day)
Silver (2 meals/day, no breakfast)
60-Meal Plan (Suite residents only) |
Roommate selection |
Do you already have a person
in mind as a roommate?
Yes
No |
Full name of preferred roommate:
(preferred roommate's housing request MUST be submitted by both individuals
and within the same or reasonable time frame)
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Living Habits |
How
do you rate your housekeeping?
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How
involved do you plan to be in extracurricular activities?
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Sleep Habits:
I like to go to sleep to music.
Yes
No
I like to sleep with the television on.
Yes
No |
What type
of music do you like?
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Study Atmosphere
I plan to study:
Early afternoon/evening
Late at night
With music or the television on
In my residence hall room
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Expected major:
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Hobbies and
interests:
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Will you be
bringing a car to campus?
Yes
No
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Statement of
agreement
In submitting this application, I assume responsibility for
the prompt payment of room, board, tuition and all other required
fees. I understand that if I am accepted in college housing,
I shall conform to all rules and regulations of the college
and residence halls. I understand that failure to comply with
these rules and regulations can result in termination from
the hall and the college. (Copies of the rules and regulations
are available in the Residence Life Office or online at www.dana.edu/residencelife).
I understand that my application will not be processed and
I will not be assigned a room on campus until I have been accepted
as a student of Dana College, paid a $100 housing deposit and
provided proof of all required medical records and immunizations.
I understand that I must be registered as a full-time student
(minimum 12 credit hours) during each semester I live on campus.
Submission of this application and/or payment of housing deposit
does not mean automatic placement in a residence hall. I understand
that once I have accepted an offer of housing and paid my $100
deposit, I will be subject to a housing cancellation fee (a
copy of this fee policy is available on request, or may be
viewed on the Dana College Residence Life website). If I wish
to cancel and reduce my financial obligations to Dana College
under this agreement, I must complete a Housing Withdrawal
Form with the Residence Life Office (E.C. Hunt Campus Center).
I understand and agree that any assignment I receive for student
housing while attending Dana College will be for the entire
academic year, but that said assignment will be subject to
cancellation at any time without refund if I fail to abide
by college and residence hall policies and regulations. I also
understand the following:
* I understand that the residence halls at Dana College are
smoke-free, and I agree to adhere to the college’s
policy of smoke-free residence hall living.
* I understand that halogen lights, which can reach temperatures
of 970-1200 degrees, are not permitted in Dana College residence
halls.
* I understand that I must leave housing during Thanksgiving,
Christmas and Spring Breaks.
* I understand that to live on campus during Discovery Term,
I must enroll in a Discovery Term course.
* I understand that the college assumes no liability for
loss or damage of any kind to a resident’s property.
* I understand resident students should secure adequate coverage,
either through their parents’ or guardians’ homeowner’s
insurance, or through additional personal insurance.
* I understand that Dana College will do everything within
its power to grant me this housing assignment. If circumstances
should warrant, the college reserves the right to revise my
housing assignment for the greater good of the campus community.
* I understand that if my roommate should not enroll, the college
will assign me a roommate or I will find my own replacement.
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