ALL APPLICANTS:

First Name:  Last Name:

E-mail Address:

Contact Phone:

I would prefer a shared bedroom apartment:  Yes    No

I am a smoker:   Yes    No

FURMAN APPLICANTS (please provide additional information)

Furman ID#: * Incoming freshman, just skip this field because you do not have an ID# yet

2009 Spring Assignment:

2009 Fall Assignment:

NON-FURMAN APPLICANTS (you MUST provide additional information)

Mailing Address:

Contact Phone:

PLEASE COMPLETE EACH SECTION BELOW:

SECTION ONE:

I plan to live in campus housing according to the dates below:

Start Date  (ex: 6/7/09) End Date  (ex: 8/15/09)

SECTION TWO (only if you need Interim Housing):

I do NOT need interim housing between May 31-June 6.

I plan to live in my current assignment (only in A, B, or C) during May X and for the summer and wish to pay for the interim period of May 31-June 6.

I will be on campus for May X, but do not currently live in A, B, or C.  Thus, I will move to my summer assignment on May 20-26 and wish to pay for the interim period of May 31-June 6.

SECTION THREE:

My housing costs should be added to my Furman account.

My housing costs will be covered by the following campus department:

Name of Department:

Contact Person:

SECTION FOUR:

Specific building preference: No SelectionBuilding ABuilding BBuilding C Apartment # (if known): No Selection101102103104105106107108201202203204205206207208301302303304305306307308

Please explain if there is a specific reason you are requesting this apartment:

My roommate preferences are (you may leave one or more blank):

Roommate #1:

Roommate #2:

Roommate #3:

Housing & Residence Life anticipates that all apartments will have four students.  Roommates will be assigned if no preferences are indicated.  Requests for private bedroom apartments will be granted based on the student's start-year in college.

The Summer Payment Form is due to Financial Services by Monday, June 8 at 5 p.m.

I understand that if I do NOT get an e-mail confirmation at the e-mail address provided above, that means that Housing & Residence Life did NOT receive my request.  It is my responsibility to check my e-mail to confirm that my request was submitted properly.

  I have read and understand the guidelines provided above.

Note: You only need to click "Submit form" once.