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Form Submission
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Residence Hall Application Form

APPLICATION/PLACEMENT PROCESS


Fields with * are required
Pronouns:
*First name:
Middle name:
*Last name:
*CTCLink ID:
*Date of birth:
*Country of Citizenship:
*I am a(an):

Current Address (if applicable)

*Street Address:
*City:
*State/Province:
*Country:
Postal Code:
*Phone:
*E-mail:
Fax:

Permanent/Home address (if different than above)

Street Address:
City:
State/Province:
Country:
Postal Code:
Phone:
E-mail:
Fax:

Emergency Contact

*Name
*Relationship
*Language
*Phone
*Email
Fax

Emergency Contact - Alternate

Name
Relationship
Language
Phone
Email
Fax

RESIDENCE HALL PREFERENCES

*What Contract do you prefer?

Additional Information:

*Which quarter do you plan to start?




Do you need to move in earlier than the specified move-in date? If so, when? * * * Room Choice: Please select your first, second, and third choice.
First:

Second:

Third:

Roommate Information:
List the names of preferred roommates (if any)
1st choice: 2nd choice:
Are you on an OC Athletic team?
List any concerns or requests you have:

Personal Habits

*Do you smoke? *The OC Residential Hall is a non-smoking facility. You may smoke outside in designated areas.

*Do you drink alcohol?
*What is your sleep schedule like?




*I keep my living space:


Study habits (choose all that apply):
*I prefer to study



*Do you like to have friends and guests over:


*What do you like to do on your free time?
 
*What are you studying?
*If an international student, what is your current English ability?



*What is your native language:
Which other languages, if any, do you speak?

*I prefer to room with:



*Do you have any dietary restrictions?

If yes, please describe:


The OC Residence Hall works closely alongside Access Services regarding all disability-related housing accommodations. To request a housing accommodation such as a bottom-story room, an Emotional Support Animal, or an ADA unit, please reach out directly to Access Services at accessservices@olympic.edu.

For non-disability related requests or information, please comment here:


I have read and understand the information provided in the Residence Hall application. The information I provided on the application is truthful and accurate. I understand that by signing the application I agree to the rules and regulations listed and will participate in the Residence Hall option to the best of my ability.

*Signature/Name:
* Date:


PAYMENT METHOD
*I will pay $150.00 (USD) with following method: