For Freshmen: Lawrence and Thayer Halls Housing and Meal Plan Contract and Roommate Questionnaire
|
| First Name: |
|
| Last Name: |
|
| Gender: |
Male Female |
| Date of Birth (mm/dd/yyyy): |
|
| Point Park ID No: |
|
Cell Phone Number (xxx-xxx-xxxx):
|
|
Home Phone Number (xxx-xxx-xxxx):
|
|
| E-mail Address: |
|
| Permanent Home Address: |
|
| City: |
|
| State: |
|
| Zip Code: |
|
| County (e.g., Allegheny County): |
|
| Name of Parent or Legal Guardian: |
|
Relationship to Student:
|
|
Parent or Legal Guardian Phone Number (xxx-xxx-xxxx): |
|
Residence Hall Selection
|
| Room Selection: |
Single Room - $3,590 per semester Double Room - $2,430 per semester Triple Room - $2,200 per semester
Click here to pay housing deposit
|
| I require air conditioning and/or a single room for medical reasons: |
Yes No |
Select Your Meal Plan
|
| Meal Plan Selection: |
14+$200 Flex Dollars - $2,680 Per Semester 10+$275 Flex Dollars - $2,500 Per Semester
|
Roommate Questionnaire
|
|
Student's Age:
|
|
|
Entry Status:
|
Freshman Transfer
|
| Intended Major: |
|
|
If possible, I prefer a roommate with the same major as me:
|
Yes No No Preference
|
|
Maintaining a "neat" room is:
|
Not important Somewhat important Very important
|
|
What time do you prefer to go to sleep?
|
Early Evening (8 to 10 p.m.) Late Evening (10 p.m. to 12 a.m.) Early Morning (12 to 2 a.m.)
|
|
Are there any incoming students that you would like to request as a roommate?
If yes, provide name(s):
|
Yes No
|
|
I am a shy/quiet person:
|
Yes No
|
|
I am an outgoing person:
|
Yes No
|
Living and Learning Communities (LLC) Programs. To be completed by incoming freshmen residents only.
|
| The Living and Learning Community (LLC) Programming, as a part of the Office of Campus Life, is designed to assist in the process of establishing Living and Learning Communities within the residence halls of Point Park University. The goal of the Office of Campus Life and the Living and Learning Community Programming is to provide all students with citizenship and conflict resolution skills, the practice of civil interaction, clarity of communication, and self awareness. |
| First Choice LLC: |
|
| Second Choice LLC: |
|
| Third Choice LLC: |
|
Signature
|
| i have read, understand and agree to abide by the provisions of this contract as explained in the Housing and Food Service Terms and Conditions |
Yes |
| The student submitting this contract electronically shall be held responsible to all of the terms and conditions of the contract and all university policies. |
Yes |
Print a Copy for Your Records
|
| A copy of this contract and questionnaire for your records before submitting the form. Select File from the menu, choose Print Preview, and then click on the Print icon |
| ALL QUESTIONS ON THIS CONTRACT AND QUESTIONNAIRE MUST BE ANSWERED. INCOMPLETE FORMS WILL NOT BE ACCEPTED. YOU WILL BE ASKED TO RESUBMIT THIS FORM IF ANY QUESTIONS ARE UNANSWERED. |
|
|
| TO BE COMPLETED BY THE OFFICE OF CAMPUS LIFE AFTER FORM IS SUBMITTED |
| |
| |