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Student Life
Student Housing

Undergraduate Summer Housing Participation Form

Summer housing will be available to all undergraduate students currently residing in the Regent Commons or Regent Village.

Student Name*
First Middle Last
Banner ID#*
Class Rank*
- Freshman
- Sophomore
- Junior
- Senior
Current Housing Assignment (Building/Rm. #)*
Gender*
- Male
- Female
Date of Birth*
MM
DD
YYYY
Room Preference #1*
Room Preference #2*
Room Preference #3*
Requested Roommate
Roommate requests must be mutual in order to be considered for assignment by Residence Life staff.
Phone Number*
Regent Email*
Reason(s) for Summer Housing*
Check all that apply.
- Select All
- On-Campus Courses
- Campus Employment
- University Approved Internship
Number of registered credits*
Must be at least one on-campus class for the summer term.
Campus Employer*
Employer Phone*
Academic Advisor*
Advisor Phone*
By signing and submitting this form you are indicating that you plan to reside in on-campus student housing for the summer months of 2021 (May - August).

By NOT signing and submitting this form you are agreeing that you will NOT have a 2021 summer campus housing assignment.
Signature
Date*
Date Format: MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

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