RESIDENCE HALL APPLICATION
Student ID
Last Name First Name Middle Name
Date of Birth 01 02 03 04 05 06 07 08 09 10 11 12 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 Gender Male Female
Home Phone Alternate Phone
Emergency Contact: Relationship
Term Summer 2008 Fall 2008 Winter 2009 Summer 2009 Fall 2009 Winter 2010
Academic Major Accounting Information Systems African American Studies Art Art Therapy Biology Business with Concentration: Accounting Business with Concentration: Business Administration Business with Concentration: Financial Planning Business with Concentratiom: Management Business with Concentration: Marketing Chemistry Child Development Child Welfare Computer Graphics (Post Bachelor) Computer Information Systems Dance Detroit Studies Early Childhood Educatioin English Environmental Science Fine Arts General Science Gerontology History International Studies in Language, Business and Culture Language Arts Mathematics Music Sacred Music Music Voice and Instrumental Native American Studies Political Science Pre-Medical/Pre-Dental Pre-Law Psychology Religious Studies Social Science Social Studies Social Work Special Education Teacher Certification Translation-Spanish, French, Arabic Women Studies Undecided Preferred Roommate No preference If you have not selected a roommate, the Office of Residence Life would like to make a reasonable attempt to assign a roommate to you who has similar interest. Please indicate anything you would like a potential roommate to know about you: Accommodations: Please indicate any physical, academic or personal accommodations you will need during your stay in the residence hall: Fees: Security Deposit: $250 per year Health Insurance*: Price to be determined. This fee may be waived if student shows proof of coverage from another plan and sign a waiver form. Students will be expected to show proof every semester. If insurance lapses, a fee will immediately be added to the student's account. (*The fee is subject to change) Room and Board: $3,400 per semester: Double Occupancy, 17 meals per week included. $3,075 per semester: Double Occupancy, 12 meals per week included. $3,075 per semester: Triple to Quad Occupancy, 17 meals per week included.
Preferred Roommate No preference If you have not selected a roommate, the Office of Residence Life would like to make a reasonable attempt to assign a roommate to you who has similar interest. Please indicate anything you would like a potential roommate to know about you:
If you have not selected a roommate, the Office of Residence Life would like to make a reasonable attempt to assign a roommate to you who has similar interest. Please indicate anything you would like a potential roommate to know about you:
Accommodations: Please indicate any physical, academic or personal accommodations you will need during your stay in the residence hall:
Fees:
Security Deposit: $250 per year Health Insurance*: Price to be determined. This fee may be waived if student shows proof of coverage from another plan and sign a waiver form. Students will be expected to show proof every semester. If insurance lapses, a fee will immediately be added to the student's account. (*The fee is subject to change) Room and Board: $3,400 per semester: Double Occupancy, 17 meals per week included. $3,075 per semester: Double Occupancy, 12 meals per week included. $3,075 per semester: Triple to Quad Occupancy, 17 meals per week included.
Security Deposit: $250 per year
Health Insurance*: Price to be determined. This fee may be waived if student shows proof of coverage from another plan and sign a waiver form. Students will be expected to show proof every semester. If insurance lapses, a fee will immediately be added to the student's account. (*The fee is subject to change)
Room and Board:
$3,400 per semester: Double Occupancy, 17 meals per week included. $3,075 per semester: Double Occupancy, 12 meals per week included. $3,075 per semester: Triple to Quad Occupancy, 17 meals per week included.
$3,400 per semester: Double Occupancy, 17 meals per week included.
$3,075 per semester: Double Occupancy, 12 meals per week included.
$2,725 per semester: Triple to Quad Occupancy, 12 meals per week included.
Review and accept the agreements.
Note: Marygrove College will make every effort to accommodate requests. However, we cannot guarantee all requests will be made. An application to reside in the residence halls does not guarantee an assignment. Students will be asked to set up an interview with an appropriate member of the Residence Hall staff prior to moving into the Residence Hall who will review the policies, procedures and expectations. Students who are unwilling to comply or who have been in violation of any college policy, may not be granted a room assignment.
Clicking "I accept" means that you agree to the Residence Hall terms and conditions.