Dorm Residence Application

Profile Information

English Level

Beginner
Intermediate
Advanced

Languages Spoken

Occupation

Religion

How would you describe your personality? Check all the boxes that describe you:

Quiet
Shy
Messy
Open-minded
Outgoing
Independent
Tidy
Cautious
Religious
Cheerful
Frugal
Organized
Private
Talkative
Athletic
Energetic
Noisy
Picky Eater
Serious
Nervous
Calm
Other

Please describe:

Do you smoke?

Yes
No

Can you live with a smoker?

Yes
No

Do you have any health concerns?

Yes
No

Please explain:

Housing Needs

Room Type

Shared room from $950 per month
Private room from $1650 per month

Arrival Date*

Departure Date*

What is the purpose of your visit?*

School
Internship
Research

Address of Your School or Employer*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Travel Information

Arrival Date

Arrival Time

:

Airport

Airline

Flight Number

Flight Origin

Do you require airport pickup?

Yes
No

Will you have the use of an automobile?

Yes
No

Reservation

To reserve your accommodation, we require a one-time, non-refundable placement fee of $75. This fee guarantees your placement. You may pay your placement fee by credit card, wire transfer or bank draft. Once you submit this form, we will contact you to make payment arrangements.

By clicking below, you are certifying that the information provided above is complete and accurate. You are also acknowledging that you have read and understood our legal notices, and that you are at least 13 years old.

CAPTCHA

Step 1 of 2

Profile Information

Housing Needs

Travel Information

Reservation