Within Reach. Beyond Imagination.
1 888 953 1133 selkirk.ca
Last Name: First Name: Initial:
Area Code: ( ) Phone Number(s): Email(s) most used:
Address: City/Province: Postal Code:
Year of Study: 1 2 3 4 Are you interested in parking a vehicle? Yes No Vehicle model/make:
Student ID Number: Program of Study: Are you: Full time Part-time
Date of Birth (dd/mm/yy): Age: Gender: Prefer not to say:
When would you like to start living in Student Housing?
Fall Semester Only – Beginning September and ending December (subject to change and specic course end date)
Winter Semester Only – Beginning January and ending April (subject to change and specic course end date)
Spring Semester Only – Beginning May and ending August (subject to change and specic course end date)
Fall and Winter Semesters – Beginning September and ending April (subject to change and specic course end date)
Request to stay over Winter Break – $250.00 will be added to rst term fees
Other – Start date (dd/mm/yy): End date (dd/mm/yy):
Student Housing Preference
Please rank the options below in order of your preference. Please note that while we will try and accommodate your preference(s), we cannot guarantee that
you will be placed accordingly.
Unit Type Occupancy Rank 1 to 6
5 Pod Front Bedroom: Private bedroom with desk, under bed storage and closet; shared kitchen, bathroom, laundry
and living area with Pod mates.
5 person
5 Pod Back Bedroom: Private bedroom with desk, under bed storage and closet; shared kitchen, bathroom, laundry
and living area with Pod mates.
5 person
3 Pod Bedroom: Private bedroom with desk, under bed storage and closet; shared kitchen, bathroom, laundry and
living area with Pod mates.
3 person
Shared Dorm: 1 shared room with 2 desks, 2 loft beds, 2 wardrobes, 2 mini fridges, 1 microwave. Shared washroom &
kitchen with oor mates.
2 person
Single Dorm: 1 bedroom, single bed with desk, under bed storage, wardrobe, microwave and mini fridge; shared washroom,
kitchen and living area.
1 person
Suite: double bed with under bed storage, wardrobe, desk, full bath and small kitchen. 1 or 2 person
**Early arrival fee: $25/night for every night prior to the specied move-in date.
** Student Housing is closed over the Winter break. Students wishing to remain in housing over the holidays will be charged an additional $250.00.
APPLICATION FOR
STUDENT HOUSING:
TENTH STREET
STUDENT
HOUSING
Within Reach. Beyond Imagination.
1 888 953 1133 selkirk.ca
Do you have any mobility concerns? Yes No Please list mobility concerns:
Alcohol Use: Do you drink alcohol? Yes Occasionally Regularly No
Smoker Use: Do you smoke*? Yes Occasionally Regularly No
Do you prefer your Pod/Floor to be: Co-Ed Female only Male only
Do you prefer to be: Social Average Quiet
How to do keep your living space? Tidy Very Tidy
Room Assignments
Please indicate below if you have a roommate request. An attempt will be made to place together those students who would like to share a Pod.
Please ll out the questions below honestly and accurately as this will help us in placing you in a compatible room assignment that most closely suits your
lifestyle preferences. Tenth Street Student Housing is a smoke free facility. Smoking is only allowed 25 meters away from the building.
Application Fee & Room Deposit
Applications will be processed only when accompanied by $50.00 non-refundable application fee. All payments must be made in Canadian
Funds and can be made either by certified cheque, bank draft, Visa or Mastercard. Please make cheques payable to SELKIRK COLLEGE.
Application Prioritization
Applications for Student Housing are accepted from students enrolled at Selkirk College with a minimum 50% course load. Full- time students requiring
accommodation for the entire academic year are given preference. Students taking less than 50% will need special permission to stay in Student
Housing. All applications are prioritized by application date and in accordance with Admissions Policy. References may be requested.
Application does not guarantee assignment.
Last Name: First Name: Initial:
Last Name: First Name: Initial:
Address: City/Province: Postal Code:
Address: City/Province: Postal Code:
Phone Number(s): Email(s) most used:
Phone Number(s): Email(s) most used:
APPLICATION FOR
STUDENT HOUSING:
TENTH STREET
STUDENT
HOUSING
Within Reach. Beyond Imagination.
1 888 953 1133 selkirk.ca
Please DO NOT send payments to the
Student Housing O
ce.
Return completed form to:
Student Housing, Tenth Street Campus, Selkirk College
702 Tenth Street, Nelson BC, V1L 3C7
Ph: 250-505-1393
Fax: 250-505-1391
Email: tenthstreethousing@selkirk.ca
Fees & Payment Information
If attending regular semester programs, you may either pay by two installments (see due dates below) or the whole amount. For all other programs, full
payment is required six (6) weeks prior to program start date.
*Refundable deposit is returned after resident checks out, less any costs are incurred for damage or cleaning.
Application Fee due during submission $50.00 (non-refundable)
Damage/Cleaning Deposit due upon acceptence $400.00 (refundable*)
Non-Regular Session. Full amount at assigned room rate due six (6) weeks prior to program start date
Rental Fee due dates (see Student Housing Preference for term fee amounts):
1st Term due July 15th for Fall Term or 6 weeks prior to start date
2nd Term due November 15th for Winter Term or 6 weeks prior to start date
Students awaiting student loans, scholarships &/or bursaries must sign a promissory note and submit with a copy of your Loan Assessment conrming the
expected amount of entitlement and date of disbursement. All Students regardless of how they are funded; student loans, scholarships &/or bursaries, are
required to pay a minimum one month room fees plus damage/cleaning deposit by the above mentioned due date or 6 weeks prior to move-in.
I understand that if I become a student in Student Housing, I must abide by the Rules and Standards of Student Housing and the
Student Housing License Agreement.
Signature Date
Signature of Guardian (if under 18) Date
APPLICATION FOR
STUDENT HOUSING:
TENTH STREET
STUDENT
HOUSING
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