Harrisburg Summer 2013 Housing Contract

*denotes a required field

*Student Last Name:		*First Name:
*Student ID #:	Campus Box #:			Gender: Male Female
*Email Address:
Cell Phone #:
Current Housing Assignment (if living on campus)	Current Hall/Apt.:		Room #:
Fall 2013 Housing Assignment	Fall 2013 Hall/Apt, Philly or Study Abroad Location.:		Room #:
Dates you will live in Harrisburg (summer housing is available between May 19 and August 17). Students can stay on Grantham's campus until May 13 and can move to their fall assignment as early as August 16 or as late as August 23).
From?			To?
Please list your roommate preference.
Name(s)?
Please explain why you're interested in living in Harrisburg housing for the summer of 2013?
IMPORTANT INFORMATION - HOUSING CONTRACT: All Harrisburg summer student residents agree to the following terms while living in college housing: Keys must be returned to the Harrisburg RA when individuals terminate residence. Lost key charge is $75 By signing this contract you agree to abide by the Community Covenant and the Policies stated in the Student Handbook. I have read all of the information on this housing contract and my selection below acknowledges that I accept (or do not accept) the dates and terms contained here. I accept the terms I do not accept the terms

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