Gonzaga Hall

2017Fall Housing Application
(New International Student)
Application Category / Exchange St. GSIS Graduates Undergraduates
/ ※You should send your photo file by e-mail with this form
(*.jpg form)

If you are

1) Exchange Students, please contact with office of international affairs .below

☎ 705-8118/ web site – /E-mail :

2) GSIS (Students of Graduate School of International Studies), please contact with office of Graduate School of International Studies

☎ 705-8753/ web site - / E-mail:

3) Graduate Students (Foreign Studentsof Graduate School,theregularcourse), please contact with office of Graduate school

☎ 705-8168 / Web site - / E-mail :

4) Undergraduate Students (Foreign students, theregularcourse), please contact with Gonzaga office

☎ 705-8811/ Web Site – /E-mail :

PERSONAL INFORMATION
Surname / Givenname
Gender / Male / Female
/ Date of Birth / / / /
MM / DD / YYYY
Student No.
(Examinee’s Slate
Number) / Major
Nationality
E-mail
Life style / Type of Activity / Early bird / Night owl .
Smoking / Smoking / Non-smoking .
Frequency of Cleaning / Over three times a week / One or two times a week .

** Room Type: Double(2 students per room)

Occupancy Period
Fall Semester(16 weeks, 8.26~12.22) / Fall Semester + WinterVacation(25 weeks, 8.26~2.9)
Meal type
A type(60% of total meals) / B type(85% of total meals) / No Meals(Students can buy meal tickets individually)
Check-in / Check-out schedule

►Check-indate:Aug.25 (Fri), 2017 ~ Aug.26(Sat), 2017

► Check-outdate: [16 weeks ]Dec. 23(Sat.), 2017/ [25 weeks]Feb. 10(Sat), 2018

I certify that the information on this application is true, complete and accurate. I agree to the conditionsoutlined on the housing web site ( I understandthat any misrepresentation of facts on my application is deemed a violation of the Gonzaga Hall Housing Agreement and results in the lossof housing privileges.

Signature / Date
Agreement to Collection & Use of Personal Information(Required)
Gonzaga Hall collects personal information when you apply for Gonzaga hall, and when you live in the dormitory. Gonzaga hall uses information only for following purposes.
1. Information Collection
- Name, student ID, major, grade, date of birth, address, phone number, mobile number, email address, GPA, guardian(Name, address, contact information), life style
2. Purposes
- Sellction for dormitory residence, Online service providing, Supervision
3. Period of use and retention of personal information
- Gonzaga Hall deletes collected personal information after the purposes are fulfilled.
4. Sharing of personal information
Company / Purposes / Period of use and retention
(Inc.)WITHVISION SYSTEM / Online service(Home page) / Until the date prescribed purpose is fulfilled
Company / Purposes / Period of use and retention
ACTIONTECH / Management of access control system / Until the date prescribed purpose is fulfilled
5. Provision of Personal Information to Third-Party
Company / Purposes / Period of use and retention
(Inc.) DONGWON
HOME FOOD / Meal providing / Until the date prescribed purpose is fulfilled
Do you agree to collection and use of personal information?
agree / disagree
* You have a right to disagree. However, if you do not agree, you are not able to apply for the dormitory.
Agreement to Provision of Personal Information to Third-Party (Optional)
Gonzaga Hall provides personal information to third-party only when the user agrees and according to the personal information protection act.
Do you agree to provision of personal information to third-party?
agree / disagree
* You have a right to disagree. It does not limit your applicationprocess.