ArtHouse Request Form Spring 2018
Please send questions to residence_life@pnca.edu
You may also contact ArtHouse directly at: 503.467.4909
Last Name *
Your answer
First Name *
Your answer
Preferred Name (nickname)? *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Please identify your academic standing for Spring 2018 *
Please select your first preference for room type *
Rates below are for the academic year (8/23/2017 through 5/13/2018)
Please select your second preference for room type *
Rates below are for the academic year (8/23/2017 through 5/13/2018)
Do you have a third preference?
Rates below are for the academic year (8/23/2017 through 5/13/2018)
Are you interested in living on a 'Chem Free' floor? *
If there is adequate interest, PNCA will designate a floor as free from alcohol and other controlled substances.
I understand that as an ArtHouse Resident I am expected to abide by the PNCA Student Code of Conduct and the ArtHouse Resource and Procedure Guide *
Required
I understand that the $300 deposit is non-refundable should I decide to cancel. *
The deposit converts to a refundable security deposit (less room damages) if I reside in ArtHouse. Cancellations, however, are not refunded.
Required
After Roommates are assigned, do we have your permission to share your contact info with your assigned roommate? *
We generally introduce matched roommates, via email, the first week in August.
Are you requesting any specific housing accommodations?
If so, please specify.
Your answer
Is there any other information you would like to provide?
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent Guardian Phone Number *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Mailing Address (street) *
Your answer
Parent/Guardian Mailing Address (city) *
Your answer
Parent/Guardian Mailing Address (State) *
Your answer
Parent/Guardian Mailing Address (Zip) *
Your answer
This is the address for: *
Required
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