2016 COLORADO COLLEGE SUMMER SESSION

APPLICATION FOR CC UNDERGRADUATES

ON-CAMPUS STUDENT HOUSING

All undergraduate students wishing to live on campus during the summer must fill out this application.

Submit to the Housing and Conferences Office or email to .

Housing is offered on a limited basis. Priority is given to students who submit their application by April 30, 2016. Available spaces are filled on a first come, first served basis. This agreement is for the 2016 Summer Session only. It may be terminated by Colorado College if the terms and conditions of residence living stated here and other regulations of Colorado College are violated. Students will receive their room assignments via the e-mail address provided on this application about a week prior to the start of the session.

DIRECTIONS: Fill out electronically by clicking in gray box and tabbing to next field. Fields expand as needed.

You may also complete by hand and email scanned copy or post to address, above.

ALL APPLICANTS: (Please print)

Last name: / First name: / Middle: / CC ID#:
Current mailing address: Street:
City: / State: / Zip:
Cell Phone: / Date when this address is no longer valid:
Permanent mailing address: Street:
City: / State: / Zip:
Phone number: / Additional phone numbers:
Fax number, if available: / Preferred email address:
Date of birth (mm/dd/yr): / Place of birth: / Gender:

ROOM AND MEAL PLAN REQUEST

I am in need of on-campus housing between: (check all that apply)
May 12 – May 17 (Extended Stay Housing)
May 18 – May 31 (Gap Housing)
June 1 – June 24 (Block A)
June 27 – July 21 (Block B)
Other: to
By applying for this accommodation, I understand that (please check each box)
I am requesting Gap Housing for the entire period (May 18-May 31) at a rate $420 or I am requesting gap housing at $35 per night for less than full gap housing period (charges will be applied to our student account)
I am responsible for moving my belongings from my current room to my summer housing room on May 18, from Noon - 5 pm
I must follow proper checkout and check-in procedures for this move
I have read and agree to the conditions stated above. Signature: (typed or signed)

I wish to apply for a room for:

Block A: (June 1 – June 24) / Block B (June 27 - July 21) / Other Dates: From to
SLOCUM - SINGLE / $740 per block
SLOCUM - DOUBLE ROOM / $690 per block
Double room: If applicable, please indicate the name(s) of the friend (s) with whom you’d like to share your room. Your friend(s) must also request you in order for us to assign you a space together. I would like to share a room with Name(s):
Continued on page two.
MEAL PLAN OPTIONS – You must select one of the meal plans if living on-campus. See website for meal plan details. If blank, Option 3 will be billed to your account
Estimated 2016 rates / FYI 2015 rates
PLAN 1: Full meal plan(2 meals a day and approx. $100 Tiger Bucks) / $525 * / $512
PLAN 2: Half meal plan (1 meal a day and approx. $100 Tiger Bucks) / $320 * / $310
PLAN 3: $100 Tiger Bucks only / $115 * / $110
* Pending Board approval Feb. 2016

EMERGENCY CONTACT INFORMATION

Name: / Relationship to student:
Street address: / City / State: / Zip:
Primary phone number: / Additional phone numbers:

FINANCIALLY RESPONSIBLE PARTY

Name: / Relationship to student:
Street address: / City / State: / Zip:
Primary phone number: / Additional phone numbers:

The delivery of this agreement by Colorado College to the student constitutes an offer of housing accommodations within the limits of available on-campus residential housing. The signing of this form by the student and/or parent/guardian constitutes its acceptance. In the event that on-campus residential housing is not available, students will receive notification from the

Housing and Conferences Office.

Payment is expected in accordance with the terms and conditions set forth by Colorado College’s Business Office. Please refer to http://www.coloradocollege.edu/offices/studentaccounts/tuition-policy.dot for details of your financial obligations and the college’s refund policy.

I have read and agree to potential financial charges as indicated above, per my typed signature as financially responsible party.
Signature of Financially Responsible Party:
(must be parent or legal guardian if applicant is under 18 years of age)

Check-In: The residence halls will open on the afternoon prior to the start of the block. Students may arrive anytime after 12:00 p.m. on that day. Instructions for where to check in and pick up keys will be included in the room assignment email that you’ll receive about week prior to the start of your class.

Undergraduate Housing Application for: Page 2 of 2