Honors Housing Application (for Upperclass Students)

For more information, please contact Daniel.Schraeder@wright.edu

I wish to apply for Honors Housing for 2012-13

First Name:
Middle Initial:
Last Name:

I currently live in:
Room or apartment number:
Bedroom (if in apartments):


I have roommate request(s) : No Yes
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)












I have a physical disability and require an adapted living space

Personal attendant

Assistance animal

Visual fire alarm

Wheelchair

Other
(please explain):

 

E-mail address:
Cell Phone: (with area code xxx-xxx-xxxx)
Contact Phone: (with area code xxx-xxx-xxxx)


I have read and understand the Terms and Conditions


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.