I wish to apply for Honors Housing for 2012-13

I currently live in: (Select One) FL - Aspen FL - Palms FL - Sequoia FL - Sycamore Hamilton South Hamilton West Honors East Honors North Honors West College Park 2120 College Park 2130 College Park 2140 College Park 2150 College Park 2160 College Park 2170 College Park 2184 College Park 2196 University Park 2060 University Park 2070 University Park 2080 University Park 2090 Woods Boston Woods Cedar Woods Hawthorn Woods Hickory Woods Jacob Woods Laurel Woods Maple Woods Oak Woods Pine Village 2030 Village 2040 Village 2050
Room or apartment number:
Bedroom (if in apartments): (Select One) a b c d ?

What is your personal reason for applying for Honors Housing?

I have roommate request(s) : No Yes This field is required.
If yes, please fill out Name(s) below:

(first name) (last name)
(first name) (last name)
(first name) (last name)

Please remember your Requested Roommate(s) must fill out their own Application(s)

How do you know the other individuals in your group?

How will your group communicate and resolve conflicts that arise?

What other issues has your group determined may exist, and how do you plan to resolve these issues?

What programs and opportunities would you like to see offered in the Honors apartment community next year?

What programs and opportunities would you be willing to plan for the Honors apartment community next year?

I have a physical disability and require an adapted living space

E-mail address:
Cell Phone: (with area code xxx-xxx-xxxx) Please enter a valid phone number.
Contact Phone: (with area code xxx-xxx-xxxx) Please enter a valid phone number.

My signature below indicates that I have read the provided information from Wright State University and understand and consent to each of the statements.

A prepayment of $150 must be paid at the time of application to complete the Room Selection Process. Failure to pay this on time may result in cancellation of the assignment. That space may be made available to other qualified residents.

I understand that the Office of Residence Services can reassign residents as needed.

 NOTE: Please remember to print a copy of your confirmation after you submit your Application Form.