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? Alltel AT&T Rate 1 (Standard Shared Boost Bedroom—least expensive) Consumer Cellular Rate 2 (Premium Shared Cricket MetroPCS Bedrom) Nextel Rate 3 (Penthouse Shared Republic Wireless Bedroom)—most expensive Simple Mobile Sprint Straight Talk Ting T-Mobile US Cellular Verizon 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.