2015 COLORADO COLLEGE SUMMER SESSION

VISITING UNDERGRADUATE APPLICATION

FOR ON-CAMPUS STUDENT HOUSING

All undergraduate students wishing to live on campus during the summer must fill out this application.

Email to: or mail to: Summer Session/Teresa Taylor, 14 E Cache La Poudre St, Colorado Springs, CO 80903.

Housing is offered on a limited basis. Priority is given to students who submit their application by April 30, 2015. Available spaces are filled on a first come, first served basis. This agreement is for the 2015 Summer Session only. It may be terminated by Colorado College if the terms and conditions of residence living stated here and other regulations of Colorado College are violated. Students will receive their room assignments via the e-mail address provided on this application about a week prior to the start of the session.

DIRECTIONS:Fill out electronically by clicking in gray box and tabbing to next field. Fields expand as needed.

You may also complete by hand and emailscanned copy or post to address, above.

ALL APPLICANTS: (Please print)

Last name: / First name: / Middle:
Current mailing address: Street:
City: / State: / Zip:
Cell Phone: / Date when this address is no longer valid:
Permanent mailing address: Street:
City: / State: / Zip:
Phone number: / Additional phone numbers:
Fax number, if available: / Preferred email address:
Date of birth (mm/dd/yr): / Place of birth: / Gender:

ROOM AND MEAL PLAN REQUEST

Block A: (June 1 – June 24) / Block B (June 29 - July 22) / Other Dates: From to
SLOCUM - SINGLE / $700 per block
SLOCUM - DOUBLE ROOM / $650 per block
Double room: If applicable, please indicate the name(s) of the friend (s) with whom you’d like to share your room. Your friend(s) must also request you in order for us to assign you a space together. I would like to share a room with Name(s):
MEAL PLAN OPTIONS – You must select one of the meal plans if living on-campus. See website for meal plan details.If blank, Option 3 will be billed to your account
PLAN 1: Full meal plan(2 meals a day and approx. $100 flex dollars) / $512
PLAN 2: Half meal plan (1 meal a day and approx. $100 flex dollars) / $310
PLAN 3: $100 flex dollars only / $110

Continued on page two.

EMERGENCY CONTACT INFORMATION

Name: / Relationship to student:
Street address: / City / State: / Zip:
Primary phone number: / Additional phone numbers:

FINANCIALLY RESPONSIBLE PARTY

Name: / Relationship to student:
Street address: / City / State: / Zip:
Primary phone number: / Additional phone numbers:

The delivery of this agreement by Colorado College to the student constitutes an offer of housing accommodations within the limits of available on-campus residential housing. The signing of this form by the student and/or parent/guardian constitutes its acceptance. In the event that on-campus residential housing is not available, students will receive notification from Residential Life and Housing.

Payment is expected in accordance with the terms and conditions set forth by Colorado College’s Business Office. Please refer to details of your financial obligations and the college’s refund policy.

I have read and agree to potential financial charges as indicated above, per my typed signature as financially responsible party.
Signature of Financially Responsible Party:
(must be parent or legal guardian if applicant is under 18 years of age)

UNDERGRADUATE STUDENT QUESTIONS:

Entering CC as Transfer Student / Entering CC as Fall or Winter First Year
Undergraduate from another institution / HS Senior, entering college elsewhere in fall

Check-In: The residence halls will open at noon the day before start of the block. Instructions for where to check in and pick up keys will be included in the room assignment email that you’ll receive about week prior to the start of your class.

In space below or on attached sheet, please inform us of any additional facts we should know regarding your medical history.

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