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Residence Hall Application 2016
Student I.D.:(*)

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First Name:(*)

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Middle Name:

Last Name:(*)

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Date of Birth:(*)

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Cell Phone(*)

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Marygrove Email(*)

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Alternate Email:(*)

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Street Address:(*)

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Zip Code:(*)

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Select a Room Option(*)

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Select Meal Plan Option(*)

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*(Financial Aid will not cover cost in total, requires an out of pocket expense for this option)
Roommate Request 1

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Roommate Request 2

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Roommate Request 3

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HOUSING CANCELLATION-If you choose to terminate your contract during the contracted period you are still financially responsible for the full payment until and unless the vacancy is filled by another student and you will be charged a $500 cancellation fee. To initiate this process you must speak with the Director of Residence Life and fill out a Contract Cancellation Form. If you fail to meet the residency requirements, fail to make payment, or violate college policy your contract may be terminated. However, you will remain responsible for the full housing payment, per the terms of the Housing Cancellation policy, until and unless the vacancy is filled by another student.

ACCEPTANCE OF CONTRACT TERMS AND CONDITIONS-You are advised to carefully review this legally binding contract, the related policies (in the Residence Life Handbook), and ask questions before you sign the contract. Additionally, you may wish to consult a parent, trusted advisor, and/or legal counsel. This is a student Housing Contract made between the undersigned student and Marygrove College. Subject to availability and the terms and conditions of this contract, the College agrees to provide you with a space within Florent Gillet Hall. By signing this contract, you affirm that you have read and agree to abide by the terms and conditions of this contract, and all the rules, regulations and policies pertaining to residence contract as stated in the Residence Life Handbook enclosed (also online at, which is incorporated as an integral part of this contract.

HEALTH INSURANCE WAIVER-by signing below, I agree to assume all financial responsibility for health care, I release Marygrove College and its affiliates, from any claims, demands, losses, liabilities, costs and expenses, including attorney fees, made by any third party arising out of my use of my use of the waiver program, my violation of these terms and conditions, my communication of inaccurate or incomplete information, and/or my violation of the law for the 2015-2016 academic year.

All residents must maintain full-time student status (12 credit hours) and maintain a 2.0 Grade Point Average while residing in housing. If students fail to meet these requirements at any time they may be removed from campus housing. Compliance with these terms, conditions, rules, regulations and policies is a condition of this contract. Any violation of this contract or policies outlined in the Marygrove Student Handbook and Residence Life Handbook shall entitle the College to terminate this contract as provided herein. You further agree to meet with administrative staff upon request and will abide by final determination(s) made by appropriate staff with respect to violations of this contract.


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