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	Personal

1.	First Name:

2.	Middle:

3.	Last Name:

4.	Preferred Name:

5.	Home Address:

6.	City:

7.	State/Province:

8.	Postal Code:

9.	Home Phone:

10.	Date of Birth:

11.	Gender:
	Male Female

12.	Academic Status: (based on completed semesters)

Housing & Roommate

All residence halls are smoke free

Male Residence Hall:

Grantham First Floor
Grantham Second Floor
Grantham Third Floor

Female Residence Hall:

Griffin Hall
Hart Hall)
King Hall

Housing Preferences

If you are interested in being placed on the waiting list for the apartments, put the apartments as your first choice. You must live on campus one semester before being eligible to move into the apartments.

13.	First Choice:

14.	Second Choice:

15.	Third Choice:

	Meal Plan: Meal Plan Preference: If you do not check one that goes with your living status you will automatically be billed for the 20 Meal Plan.

16.

Please Select a Meal Plan:

20 Meal Plan

10 Meal Plan (Apartments only)

200 Bloc Plan

130 Bloc Plan (Apartments only)

	Roommate Preferences If you would like to request another student who has been accepted into housing, please specify below. Both you and the person you wish to live with must indicate that you would like to live together. Due to many factors we cannot guarantee all requests.

17.	First Choice:

18.	Second Choice:

19.	Third Choice:

	Personal Preferences The following information is requested in an effort to house compatible individuals together and to fulfill roommate requests. Again we cannot guarantee all requests.

20.

Which do you consider more important:

Roommate Preference

Room Assignment

21.	Please tell us about any physical disabilities you want us to know about:

22.

Do you smoke:

Yes

23.

Do you object to living with a smoker:

Yes

24.

Height - Are you over 6ft:

Yes

25.

What is your average bedtime:

By 10PM

By 11PM

After Midnight

26.

Neatness:

I'm always neat

Neat most of the time

Rarely Neat

27.

Roommate Expectations:

Roomate will never use or borrow my things without my permission

Occasionally use or borrow my things

Rarely need to seek my permission to use or borrow my things

29.	Please tell us about any Mount Olive College extracurricular activities in which you participate:

Sign Your Request

Housing assignments will only be made after the deposit is received ($50.00 for returning students). Mount Olive College reserves the right to cancel/change all housing assignments in the interest of order, health, discipline or other reasons. Students are assigned to housing without regard of their age, color, disability, gender, national origin, race or religion.

I have read and understood the above statement.

31.	Signature:*

32.	Email:*

33.	Date:*
	mm/dd/yyyy

Personal

Housing & Roommate

Housing Preferences

Meal Plan:

Roommate Preferences

Personal Preferences

Sign Your Request