New Student Request | Campus Living SIC

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New Student Housing Agreement

First Name

Last Name

Student's email

Student's Phone

Additional Info - roommate request/private room request

Choose an option

Student's Birthday

Choose an option

Please Note:

Cardholder's Name

Card Number

Expiration Date

CVV (3 numbers on back of card)

Cardholder's Zip Code

Receive receipt? text or email - list below

Disclaimer:

I have read the Terms and Conditions of Occupancy and the Housing Resident Docket.

Thanks for submitting! Please note: your card payment will not be processed at the time of submission. You will receive your receipt at the time our office runs your payment.

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