Small Group Housing Application form

Please take a few minutes to complete the items below.

Contact Person

( ) -


Please list your first 3 preferences for housing units:

Willingness to accept transfer students to reach capacity: Yes No 


Write “Fall” or “Spring” or “May” to indicate if a group member will be gone on for SST, BCA or other reason next year. Write “N/A” if the group member will be living in the house both semesters and May term.

Names of Group Members Student ID Number # of Years Since HS Graduation Date of Birth
Present Address: Off-Campus or Dorm SST, BCA, etc.
(Fall, Spring, or May)