Summer 2017 Housing Request Form
Please complete this form if you are requesting to reside on campus after May 21. Note that summer housing at Collegiate Village is unavailable.
What is your First Name?
What is your Last Name?
What is your cell phone number?
Please use the xxx-xxx-xxxx format
What year do you anticipate Graduating from Daemen?
I do not anticipate graduating from Daemen
Are you a current Daemen student?
Housing is only available for Daemen College students.
Not yet, but I will be as of May 15
For which time period would you like housing?
Summer Session I (June 4-July 8)
Summer Session II (July 9-August 10)
Summer Session III (June 4- August 10)
I'm enrolled in the Athletic Training Program
A specific time period, please note below in the 'other' section
I understand that Session I move in day is June 4 starting at 12 noon, and Session II move in day is July 9 at 12 noon. Move Out Day for Session I is July 8, and move out day for Session II and III is August 10.
For what reason do you need summer housing on campus?
Classes at Daemen
Internship in Buffalo
Working for Residence Life, Conference Services or Orientation
I understand that I will be paired with three other roommates for the summer. However, there is someone with whom I'd like placed in my apartment. That person's name is:
Both apartment mates must write each others names in order to be placed together.
What is the name of an emergency contact for you?
What is that person's relationship to you?
What is the phone number of that emergency contact?
Please use the xxx-xxx-xxxx format.
What day to you wish to move into the Campus Apartments?
Please note this is not confirmed until you receive an email from Residence Life
What day to you wish to move out of the Campus Apartments?
I understand the Housing fee will be applied to my student bill in the following amount: $175/week in Campus Apartments.
Send me a copy of my responses.
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