THE UNIVERSITY OF TEXAS AT EL PASO
STUDENT HOUSING APPLICATION
Academic Year 2010-2011
THE UNIVERSITY OF TEXAS AT EL PASO does not discriminate on the basis of race, color, national origin, sex, religion,
or disability for employment or provision of services. This application is available in an alternate format upon request.
PART ONE: GENERAL INFORMATION (please print)
Name______Gender M / F UTEP ID______
Family Name (Last) First MI
Mailing Address______
# and Street City State Zip Code
Contact Phone Number______Contact email ______
CRIMINAL HISTORY: Have you ever been convicted of a felony or misdemeanor (excluding minor traffic offenses)? ___Yes ___No
If ‘Yes’ list all offense(s) below. Please be aware that this information will only be used to determine your eligibility to live in
Student Housing.
Felony/Misdemeanor Date of Conviction County/State of Conviction
______
PLEASE MARK YOUR PREFERRED LOCATION AND ROOM STYLE IN NUMERICAL ORDER BELOW.
NOTE: While every effort will be made to accommodate your housing request on a first-come, first-serve basis,
keep in mind that not all room styles may be available at the time of your application.
ACKNOWLEDGEMENT OF APPLICATION AND ON-CAMPUS REQUIREMENTS
MENINGITIS VACCINATION REQUIREMENT: The Texas State Legislature has passed a law in January 2010 which
requires all new on-campus residents in the state of Texas to be vaccinated for meningitis. Details regarding
this new requirement will be shared by visiting the following link: www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf or by contacting the UTEP Student Health Center at 915-747-5624.
HOUSING DEPOSIT REQUIREMENT: All applications must be accompanied by a housing deposit of $200.00 to be considered for a room assignment. This amount will be charged on the student’s account immediately after receipt of this application. NOTE: The student may cancel this housing application by submitting a request in writing to the Director of Residence Life before a room is assigned. If a room has been assigned, cancellations and refunds will be handled as covered in the Terms and Conditions section of the Housing Contract.
By signing below, I understand the requirements listed above and I agree that all information I submit is accurate.
______
Student Signature Date Guarantor’s Signature Date
(Parent’s/Legal Guardian’s Signature)
PART TWO: ROOMMATE PAIRING INFORMATION
It is our hope that your stay on the UTEP campus will be enjoyable as you pursue your educational goals. To help us before you arrive, please
take a few moments to answer the following questions honestly, and we will do our best to match you with a compatible roommate! When
you receive your room assignment, you will also be sent contact information for your new roommate(s), so that you may make plans before
you arrive. Remember: This part of “college life” may have you feeling intimidated, but it also has the potential to be a valuable “out-of-the-classroom” learning experience.
Your name ______Do you have a roommate chosen? Yes / No
If “yes” write their name here: ______(this person must do the same on their application)
Your Age ______(if under 21, date you will turn 21) ______
Your City& State ______
Are you a smoker? Yes / No Are you a UTEP Scholarship Athlete? Yes / No
Do you have a disability that would require special accommodations? *Yes / No
If Yes, please be detailed in your request here: ______
*Additional documentation may be required.
ROOMMATE SURVEY( Please give honest answers and circle the statement that best describes how you feel.)
When it comes to keeping the room clean, you can count on me to:
a) clean up my messes immediately after I make them. I am a neat freak!
b) pitch in, especially if we could put together some type of schedule.
c) pick up after myself every once in a while, but don’t ask me twice!
As a general rule, the temperature in our apartment:
a) should respond to the temperature outside
b) will stay warm throughout the year. I get cold easily!
c) will stay cold throughout the year. I get warm easily!
The best way to describe the refrigerator in my apartment is as follows:
a) all items are labeled and roommates need permission for use.
b) Items are purchased in bulk and are shared by everyone equally.
c) Both (a) and (b)
Taking my class schedule, my work schedule, and my social life into consideration, the best way to describe my sleep schedule will be:
a) I will have a regular sleep schedule, with an occasional late night.
b) I will have a unique sleep schedule, with..(circle two)
(very early mornings) (early mornings ) (late mornings) AND (early evenings) (late evenings) (late nights)
c) I can adjust to anyone’s schedule. This is not an issue for me.
My thoughts on “study times” are as follows:
a) Studying is important! I plan to block out times during the day and evening to study!
b) I’ll study some, but I also want time to be with friends and to enjoy “college life”.
c) I have little or no plans to study in my room this year.
PART THREE: SPECIAL INTEREST HOUSING OPTIONS
We would like to give you the opportunity to live on a floor with neighbors who have similar interests and motivations. To enhance your living experience here, choose one of the options below. If you have no interest in participating in one of these options, do not mark a preference; If you have more than one choice, rank them in numerical order.
_____ Academic Floors: While every resident should be concerned about their academic success at UTEP, we know that there are students who require an intensive study-oriented environment.
_____ International Floors: Interested in living with someone from another country? Learn cultures, language and traditions from your neighbors while sharing your own.
_____ Wellness Floors: If you are interested in meeting others who share your need for physical fitness, nutrition, and a commitment to an alcohol/drug free lifestyle, this is your home.
______Sacramento Living Learning Community! Twenty six first-year students will live together in the same building, take classes together, work together to accomplish group projects and explore their own potential for leadership on the UTEP campus. More information on this community can be found on our website or by calling the Summit Hall office.