Housing and Dining 2008-2009 Academic Year Contract

Please Note

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Personal Information

Banner ID:

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Country:

Home Phone:

Cell Phone:

E-Mail:

Birth Date: mm/dd/yyyy

Gender: Male Female

Major(s):

Payment

Advance Payment must accompany this contract. All other housing payments will be made at the Bursar's Office.

An exemption is available only for students who can demonstrate a financial aid or scholarship award sufficient for payment of their housing balance. A separate form must accompany this contract and pre-approval is required.

Advance Payment Amount First Time Residents: $150 fee plus $30 non-refundable application fee required Returning Residents: $100 advance payment required I want to apply for an "advance payment exemption."

Hall Preferences

Please select and rank (with first one being your first preference)

Halls available:

Hall Preference Selections and Rank:

Note: If your first preference is not available, we will attempt to assign you to your next ranked preference. If a next preference is not marked, we will assign you to a room according to availability.

Roommate Preference

1st Choice Name
Banner ID

2nd Choice Name
Banner ID

3rd Choice Name
Banner ID

Which Preference is most important? Hall Preference Roommate Preference

Meal Plan Selection

Note: If you have not indicated a meal plan and we assign you to a room that requires a meal plan, we will automatically assign the least expensive meal plan option to you.

Meal Plan Selection Broncho Max + $100 Flex 14 Meals per Week + $200 Flex 7 Meals per Week + $425 Flex 168 Block + $100 Flex 10 Meals per Week 120 Block + $200 Flex 70 Block + $425 Flex

If you are assigned to the University Commons, do you still want a meal plan?

Y N N/A

Other Preferences

Note: This directory is used in the event someone requests your room phone number.

Do you want your name and number listed in the UCO Housing Office Directory?

Yes No

Note: If yes, please contact Disability Support Services at (405) 974-2549.

Do you require adaptive or accessible housing on the basis of disability or health problem?

Yes No

Lifestyle Preference

In case of Emergency, please Notify

Name

Relationship

Phone

Address

City

State

Zip

Approvals

I give the University of Central Oklahoma permission to speak to my parent(s)/guardian(s) about my housing account.

I understand that this is an academic year contract.

I understand the "Certification of Meningococcal Compliance" section of the Terms and Conditions document.

By clicking "I Agree" below I acknowledge that I have been provided with a copy of the University of Central Oklahoma Terms and Conditions, and I agree that all of the terms, conditions, and provisions contained in that document are a part of this contract and that I am fully bound to abide by such terms, conditions, and provisions. Also, as a condition of this contract, I agree to comply with all University and Residence Life rules, regulations, and policies: the University of Central Oklahoma Code of Student Conduct, the Residence Life Student Handbook, and other posted and/or distributed rules and regulations incorporated herein by reference. This includes those now in effect and those that are amended or enacted during the term of this contract. The housing contract is valid only if a residence space is available.