WSU: Housing - Mixed Gender Housing Application

We are offering Mixed Gender Housing again this Fall in College Park Apartment buildings (2184 & 2196) for a limited number of current, qualified residents that select the option during the Room Selection Process. Residents will not be assigned to this upperclass community without their prior request. This program is designed to be both a safe environment for the GLBTQA community and a place where friends of different genders, regardless of their sexual orientation, are permitted to live together. Dating and committed couples, regardless of gender or sexual orientation, are strongly discouraged from living together in the same apartment. As you can see on our website, these apartments have four private, lockable bedroom doors and two private bathrooms. This style of living option is currently available at most off-campus apartments, and we wanted to extend this option to current residents. There will be one resident for each of the four single bedrooms in the apartment. Each apartment also has two bathrooms, a kitchen and a combination living room/dining room that will be shared by the four roommates.

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

I wish to apply for Mixed Gender Housing in College Park for 2013-14

First Name:
Middle Initial:
Last Name:
Legal Gender:

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

What is your personal reason for applying for Mixed Gender Housing?

Roommate request(s) - 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 has your group agreed to share bathroom and other common spaces in the apartment?

What has your group decided about having visitors during the day or overnight?

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?

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) 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 and watched the cartoon about Mixed Gender Housing at Wright State University and understand and consent to each of the statements.

I have read and understand the Terms and Conditions (2 semester contract - College Park)

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.