Housing Application

I am applying to live on campus starting in *

I am a
First Year Student Sophomore Junior

My full legal name is *

My mailing address is *

CityStatePostal Code


My phone number is *

My gender is *
Female Male

Date of birth*

I am a student athlete *
Yes No

If I answered yes to the previous question, my sport is

Insurance Provider/Company*

Policy Number*

Immunization records must be on file with student housing. What was the date of your last immunization shot?*

Do you have health concerns that could affect your housing room assignment?*
Yes No

In case of emergency, whom should we contact? Please list their name and relation to you.*

Emergency Contact Telephone Number*

Please select Single or Double Room and Meal Plan. A Meal Plan is required to live in Campus Housing. *
Single with 19-meal plan Single with 12-meal plan Double with 19-meal plan
Double with 12-meal plan


Along with proof of insurance, all students are required to supply their current immunization record to the Director of Housing. By submitting this application, you are stating that you have read the Student Housing Policy and understand all the terms therein.

Early move-in policy: If a non-athletic student chooses to move in before the designated move-in date set by University of the Southwest, a charge of $30 per day must be paid prior to moving in and permission must be granted by the Housing Director.

Withdrawal from University of the Southwest: There is no refund for housing or meal charges or deletions after the end of the drop/add period unless the student completely withdraws from school. Students who withdraw from school prior to the drop/add date will be charged $30 per day from the date of move into the residence halls until the date they move out. Only enrolled students may reside on campus. Therefore, arrangements to move must be made immediately upon withdrawing from school.

Dining Hall Notice: Campus housing facilities will be closed and no meals will be served during official college holidays, instructional in-service days, spring break and the interim between semesters. Any exceptions to this policy will be communicated to the student by their residence director(s).

Refund of deposit: The $125.00 refundable deposit is due prior to move-in. There is a $25.00 standard cleaning fee applied to all deposit refunds. If the student decides to cancel a room reservation prior to enrollment, written notification must be received in the Housing Office by June 15th; otherwise, the deposit may be forfeited. If the student, for any cause, is suspended or expelled from the University, the University will charge the student pro rata $30 per day from the date of the move in to the residence halls up to the suspension/expulsion date.