Fall 2021 Undergraduate Housing Application (Stamford) University of Connecticut • Division of Student Affairs • Department of Residential Life Whitney Hall, Garden Level • (860) 486-2926 • [email protected] • www.reslife.uconn.edu 2021-2022 On-Campus Housing Contract

By submitting the 2021-2022 Current Undergraduate Housing Application, I agree to abide by the 2021-2022 On- Campus Housing Contract and accept the terms and conditions of this contract.

Occupancy Period & Housing Cancellations

I understand the occupancy period is for the entire 2021-2022 academic year, and cancelling my contract to live off-campus may result in a financial penalty. Please review the housing contract for complete information about the cancellation fee schedule.

If you agree, sign your name below:

______

Signature

1. Smoking: Indicate your smoking status 3. I like to live in a room that is generally: and living preference  Casual – fairly clean, not always  Non-smoker—I don’t mind picked up living with a smoker  Messy – looks like a tornado Non-smoker—I prefer to not live  Neat – orderly and tidy with a smoker 

 Smoker - Connecticut State Law prohibits 4. I prefer the noise level in my room to be: smoking in the residence halls. Flexible – a time for noise and a - Residential Life uses this  time for quiet information in an effort to facilitate compatible roommate  High Energy – music or TV on pairings. all of the time

2. How often do you plan on having  Quiet – low key and mellow overnight guests?

 Almost never 5. When studying, I generally prefer:  Every weekend  Quiet location by myself  One a month  To study alone with background  Once a week noise or TV  Twice (or more) a week  To study with another person

 Twice a month - Please review Section 9.9 Guests in the housing contract and consult with your roommate(s) prior to inviting any guest. 6. The best way to approach me about an 10. If your cell phone carrier is not on the issue would be: list, please indicate the company so we can work with our software vendor to Schedule a meeting and talk at  add it to our list. that time

 Send me a message  Tell me face to face right away 11. Opt out of Text Messages

-Indicate “Yes” to opt out of text

messages from Residential Life. 7. Gender Identification Please indicate the gender with which  Yes you most closely identify if it is different No from your legal sex. Staff may contact 

you to determine if alternative 12. Have you been convicted of a felony, arrangements need to be made. misdemeanor (other than minor traffic violation), or is any such charge pending against you? -If yes, see confirmation email. Housing may be denied to students 8. Cell Phone Number (US Domestic convicted of a felony/misdemeanor. Phone Numbers Only):  Yes  No

9. Cell Phone Provider/Company 13. Housing Rate Preference - Used to send occasional text messages What is the highest housing rate you - Standard messaging rates apply. prefer to pay?   AT&T  Rate 1 (Standard Shared  Boost Bedroom—least expensive)  Consumer Cellular Rate 2 (Premium Shared  Cricket   MetroPCS Bedrom)  Nextel  Rate 3 (Penthouse Shared  Bedroom)—most expensive  Simple Mobile  Sprint  Straight Talk  Ting  T-Mobile  US Cellular   Virgin Mobile USA

14. Do you have a medical/health condition 16. Would you like to be contacted by our or disability that requires a specific staff to discuss potentially living in housing accommodation? substance free housing? - If yes, contact the Center for Students Yes with Disabilities to request an  accommodation.  No

Yes   No

15. Would you like to be contacted by our staff to discuss special housing considerations related to your religion?

Yes   No

Thank you for completing the housing application—you will receive a confirmation email when your application has been processed. If you have any questions or changes that you would like to make after submission, please email [email protected] and include your name and 7 digit Peoplesoft number in each response.