Residence Hall Application
  1. Are you a new or returning applicant?(*)
    Please select the type of applicant that applies to you.
  2. First Name:(*)
    Please enter your first name.
  3. Last Name:(*)
    Please enter your last name.
  4. Middle Name:
  5. Gender:(*)
    Please select your gender.
  6. Street Address:(*)
    Please insert your street address.
  7. City:(*)
    Please insert your city.
  8. State/Province:(*)
    Please select your state or province.
  9. Zip-Code:(*)
    Please enter your zip-code.
  10. Email:(*)
    Please enter a valid email address.
  11. Student I.D.:
    Invalid Input
  12. Date of Birth:
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  13. Emergency Contact Information
  14. Primary Contact:(*)
    Please enter a primary emergency contact.
  15. Relationship:(*)
    Please enter your relationship to your primary emergency contact.
  16. Pimary Phone:
    Please enter your home phone number.
  17. Secondary Phone:
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  18. Incoming College Credit Hours Completed:(*)
    Please select the appropriate description for the incoming college credit hours you've completed.
  19. Housing/Meal Plan Preference
  20. Please select one of the four occupancy rates available below.
    Note: All Freshmen and Sophomores will be quaded. Due to limited space, we cannot guarantee double occupancy to Juniors and Seniors.
  21. Double Occupancy Rates (Juniors & Seniors


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  22. Tripple to Quad Occupancy Rates (Freshman & Sophomores)


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  23. Entrance Date:(*)
    Please select your intended entrance date.
  24. Fees
  25. 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)

    Your application will not be considered complete until we receive your completed Insurance Waiver in the mail. The Insurance Waiver is available for download in the navigation to the left.

  26. Security Deposit: $250.00

    $250 Security deposit and Health Insurance Waiver must be turned in to complete the application and reserve your spot in 2010-11.

    Please mail your deposit, along with a completed Health Insurance Waiver to the address below.

    ATTN: BUSINESS OFFICE
    c/o Housing Deposit Marygrove College
    8425 W. McNichols
    Detroit, MI 48221

  27. Additional Information:
  28. The following will aid in matching you with a roommate. Room assignments are made on a first come, first serve basis after the completed application, $250 security deposit, and insurance waiver form are complete. Requests are considered but not guaranteed. Roommate requests must be mutual and indicated in writing by all parties
  29. Indended Major/Minor:(*)
    Please enter your intended Major/Minor.
  30. I consider myself:(*)



    Please make a selection.
  31. I understand that smoking is not permitted in the buildings on campus, or within 25 feet including the residence hall, and due to personal choice, allergies or sensitivities.(*)


    Please make a selection.
  32. Music Preference:(*)






    Please make a selection.
  33. Are you in the Marygrove College Honors Program?(*)
    Please make a selection.
  34. Roommate Preference: (May be a specific name or request alike majors and/or teammate)
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  35. Have you ever been convicted of, or plead guilty or no contest to a felony crime or misdemeanor (except traffic violations)?(*)
    Please make a selection.
  36. If yes, please explain:
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  37. 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.
  38. Please indicate any physical, academic, or personal accommodations you will need during your stay in the residence hall in the space provided below.
  39. Accomodations:
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  40. Review and accept the agreements.
  41. I have read and accept the terms and conditions of the Residence Hall Application Agreement.(*)
    You must accept the terms of the agreement.
  43. Please enter the two words to validate your submission.
    Invalid Input

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