University Village Application

Identification

1. Last Name(required)
2. First Name(required)
3. SSN(required)
4. Street Address
5. City(required)
6. State(required)
7. Zip Code(required)
8. Telephone(required)
9. Date of Birth(required)
10. Gender Male Female (required)
11. Email(valid email required)

Student Information

1. Commuter
2. Current Residence Hall
3. Semester you are applying for Fall 2010 Summer I 2010 Summer II 2010 Spring 2011 Fall 2011
4. Click where applicable
5. 60+ Hours Over 21 Single Parent
   Married Veteran

Housing Options

1. Apartment Type 2 Bedroom/1 Bath 4 Bedroom/2 Bath Family
2. Contract Type 9 Month 12 month 12 Month Early
3. Indicate any special health problems or disabilities that should be considered in making housing assignment.
4. Have you ever been convicted of a felony or sex-related crime?
5. If yes, please explain.

Meal Plan Options

1. All students will be on a $ 350 declining balance if a plan is not chosen.
2. Meal Plan $ 350 Declining Balance $ 450 Declining Balance 10 Meals plus $ 90 Declining Balance Unlimited Meals + $ 25 Declining Balance 5 Meals + $ 110 Declining Balance Unlimited Meals

Roommate Request(s)

1. Once you are admitted to University Village, be sure you and your roommate(s) request the same unit type. Roommate requests and/or assignments will not be processed until all applicable fees and deposits have been received. Due to space limitations, requests may not be honored. Ask about roommate matching.
2. Name 1
3. Name 2
4. Name 3

Payments

1. The only way to SECURE your room at University Village is to return a completed and signed application, proof that you are eligible and pay the $ 200 deposit. Please return application and checks to Student Life Office, PO Box 9421, Magnolia, AR 71754. In event of cancellation, your $ 200 deposit will be forfeited.

1. Type the following

 

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• Contact Information

  J Courson, Associate Dean
  Reynolds 202
  870-235-4047

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