Summer Housing Agreement Form 2016
NOTE: IF YOU ARE A CURRENT VALPARAISO UNIVERSITY STUDENT, DO NOT COMPLETE THIS FORM. PLEASE LOG ONTO YOUR DATAVU select HOUSING SELF-SERVICE and FILL OUT THE "Summer 1 and/or Summer 2 Housing Application".

THIS APPLICATION IS FOR STUDENTS WHOSE FIRST SEMESTER OF ENROLLMENT WILL BE IN THE SUMMER OF 2016.

Due to the Office of Residential Life (Harre Union 250) by Friday, April 22, 2016.

On-campus housing is available for both male and female students as space permits. Students must be registered in a credit-bearing academic course while residing in summer housing. Uptown East Apartments will be used for Summer Housing.

Apartment amenities include air-conditioning, internet, cable, furnished living room with television, kitchen with all major appliances, washer/dryer unit and private bedroom with full-sized bed and private bathroom. Apartments are provided with the necessary furniture, but students must supply their own bedding, pillows, towels, kitchen utensils, pots, pans, etc.

While summer housing is optional, once the student signs the summer housing agreement it is a binding contract for the specified summer session(s) noted on the agreement that obligates the student to live in University-operated residence halls for that full summer session(s). Students who are starting classes on other dates must check with the Office of Residential Life when submitting applications.

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Summer Housing Information and Dates:

Session I: Monday, May 16-Saturday, June 25
• All students residing in Summer I housing will reside in temporary housing for approximately 2 weeks, until space is ready in Uptown East Apartments.
• If a student is only in summer housing for Session I, the student must check out of their residence hall space by Noon on Saturday, June 25.

Session II: Sunday, June 26-Saturday, August 6
• Students residing in Summer II housing ONLY can check in starting at Noon on Sunday, June 26.
• All students will be expected to move out of summer housing by Noon on August 6.

Terms of Housing Agreement
The summer school agreement is for the entire summer session(s) as indicated below. If your particular program dates are different than the full session dates you MUST indicate this information below. The University will endeavor but cannot guarantee to assign space according to the preference indicated. Assignments are made without regard to race, color, or national origin. Students applying for summer housing must have an active housing deposit on file, or must submit a $100 deposit with this form to the Finance Office. The Housing Agreement is a binding contract that obligates the student to live in University operated residence halls for the full term or remainder thereof, as indicated by the student on this form. In case of cancellation of room reservations refund of charges and deposit will be as follows:

1) 100% Deposit refund if written notice is received by the Office of Residential Life by April 22nd for Session I and June 1st for Session II.
2) 50% Deposit refund if written notice is received by the Office of Residential Life by May 13th for Session I and June 24th for Session II.
3) The Housing Agreement may not be cancelled after May 17th for Session I and June 27th for Session II unless the student withdraws from summer school courses.

The University reserves the right to make changes in residence hall assignments if necessary for the most effective accommodation of the student body.

Student Information
Select summer term(s) for which you are requesting university housing
If the term dates of your classes/program are different than these dates, please indicate the course/program and the dates in "Other"
First Name
Your answer
Middle Initial
Your answer
Last Name
Your answer
Student ID number
Your answer
Gender
Date of Birth (month / day / year)
Your answer
Credit hours completed as of Spring 2016
Your answer
Level
Primary E-mail
Your answer
Primary Phone Number
Your answer
Primary Address
Street, City, State, Country, Postal Code
Your answer
Roommate Preferences and Single Room Information
Roommate Preference
Roommate preferences must be mutual.
Your answer
If available, would you prefer a single room?
NOTE: There is an additional charge for a single room accommodation. Single rooms are granted as space permits.
Would you like to live with a student from a country other than your own.
What are your sleeping habits?
Required
What are your study habits?
Required
Generally speaking, how do you keep your room?
Required
How do you primarily plan on using your space?
What type(s) of music do you listen to?
Required
Are you a smoker?
Do you mind living with someone who uses tobacco?
Medical Accommodations
If you have any requests for special need or disability accommodations that need to be considered, please list them below. Medical requests must have the appropriate documentation attached or on file with the Office of Residential Life. Students also may be required to meet with the University Physician, or other University offices.
Your answer
Acceptance of Terms
By typing your name, today's date and submitting this form electronically, you hereby certify that you understand and accept University housing regulations concerning assessments and refunds, and that you will comply with University regulations found in the Terms and Conditions for Residence Hall Housing, University Catalog, Student Guide to University Life, and other official publications.
Type Full Name
Your answer
Today's Date
Your answer
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