New Student Residency Contract

Prior to completing this form, make sure to read

Housing/Food Services Statement of Terms and Conditions of Occupancy.

New Student Residency Contract
  1. Semesters Attending Academic Year 2019-20(*)
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  2. Incoming Class Rank(*)
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  3. Full Name(*)
    Please type your full name.
  4. Nickname
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  5. Date of Birth(*)
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  6. E-mail(*)
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  7. Gender(*)
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  8. Home Phone
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  9. Cell Phone
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  10. Address
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  11. City
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  12. State
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  13. Zip Code
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  14. Parent/Guardian Work
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  15. Parent/Guardian Cell Phone
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  16. Parent/Guardian Email
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  17. Parent/Guardian 2 Work
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  18. Parent/Guardian Cell Phone
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  19. Parent/Guardian Email
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  20. In Case of Emergency: Contact Name
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  21. Contact Relationship to You
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  22. Contact Phone Number
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  23. *New students who are 26 years or older require permission from the Dean of Students to live on campus. Permission is granted only in special circumstances.
  24. Special Housing Needs: Students with medical or disability-related housing needs must complete the Disability Assistance eligibility process, and document their specific needs with the Director of Disability Services (910) 277-5667.
  25. (*)
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  26. This includes the use of an Emotional Support Animal or Service Animal (must be approved by Disability Services and registered with Department of Housing).
  27. If you already have identified a person with whom you wish to live, please complete the following. Important Note: Both students must request each other and submit their contracts before the assignment can be finalized.
  28. Name of requested roommate
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  29. Housing Survey
  30. Would you prefer that your roommate has the same major as you do?
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  31. If no, which major(s) would you prefer?
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  32. What academic major do you plan to study at St. Andrews?
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  33. What type of music do you enjoy? Check all that apply
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  34. If other, please give a short description of what music you enjoy
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  35. Relative to study, are you a
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  36. How many hours do you plan to study in your room per day?
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  37. Do you like to
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  38. Are you a
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  39. How do you keep your room?
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  40. Do you consider yourself
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  41. Do you prefer a roommate who is
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  42. Do you smoke?
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  43. Are you a member of a club or organization?
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  44. If yes, please list the group(s)
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  45. Are you planning to participate in athletics at St. Andrews? If yes, please check the sports that you plan to participate in:
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  46. Are you a competitive equestrian rider?
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  47. If other please describe:
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  48. Liability Renter’s Insurance: The University does not assume liability for the loss, damage or theft of any personal property; or for damage or injury resulting from explosion, fire, mechanical failure of water, steam or gas lines; or from defective wiring; or from negligence of any other occupants of the building. Students who want to protect themselves from the possibility of such losses should cover their belongings with an appropriate insurance.
  49. Residential Student Agreement: I request that the university proceed to assign room and board accommodations in keeping with the terms of this contract
  50. I acknowledge that by submitting this form, I am providing an electronic signature verifying that the information is correct as submitted and an accurate reflection of my consent as indicated above. I further verify that I have reviewed and understand the Housing/Food Services Statement of Terms and Conditions of Occupancy (Mentioned Above).