Housing Application - Manor College

Name *

First

Last

Preferred Name

Date of Birth *

Sex *

Male
Female

Address *

Address Line 1

City

State

Zip Code

Email Address *

Student ID Number

Current Cell Phone Number *

Please Identify Your Current Status *

Please Identify Your Current Class *

Which term(s) would you like on-campus housing?

Spring 2024
Fall 2024
Spring 2025

Do you have any medical conditions which may affect your housing placement? (Please know, housing and academic accommodations differ. Housing accommodations must be submitted and approved by the Office of Disability Resources.) *

No
Yes - Please email Disability Services at accessibilitiesservices@manor.edu

Do you have a roommate preference? *

Yes
No

Please list the first and last name of your desired roommate.

My emergency contact person will also serve my missing person’s contact *

In the event of an emergency, your emergency contact person will be contacted by a member of the Student Affairs team. As a residential student, you are required to provide this information to secure on-campus housing.

Relationship of your emergency contact to you

Cell phone number of emergency contact

Home phone number of emergency contact

Please provide the first and last name of your Missing Person’s contact person

Please list the relationship of your Missing Persons contact to you

Please list the cell phone number of your Missing Persons contact

Please list the home phone number of your Missing Persons contact

Subscriber Name

First

Last

All residential students are encouraged to have active health insurance while on-campus.

Subscriber Date of Birth

Subscriber relationship to student

Medical health insurance company name

Group Number

(If you do not have a group number fill in N/A.)

ID Number

(If you do not have an ID number fill in N/A.)

My Major is... *

Please complete the Roommate Survey. Although you may have identified a roommate within this application, Residence Life will use this information to rematch you, if necessary.

My personality is... *

Shy and reserved
Talkative and outgoing
A combination of the two

Are you a Manor athlete? *

Yes
No

Do you prefer to live with someone that is an athlete? *

Yes
No
No preference

Do you prefer to live with someone with the same major as you? *

Yes
No
No preference

I consider myself to be... *

Night owl
Early bird
A bit of both

I like my room to be... *

Clean and tidy
Messy
Somewhere in between

In my room, I like to be.... *

Social with people around
Quiet
A combination of the two

On weekends, I hope to... *

Stay and hang out on the weekends
Go home and work on other stuff
Depends on what's going on

I plan to study... *

In my room
Other places on campus

Which matters the most to you when selecting a roommate? *

Please include any additional information you want the Residence Life team to know about you: *

If nothing, write N/A