Date Received
|dd |mm |yyyy |
|dd |mm |yyyy |
Date Room Extension Approved
|dd |mm |yyyy |
3330 22
Ave · Prince George BC · V2N 1P8 · p 250 561 5849 · tf 800 371 8111 · e · w CNC PG Campus Housing EXT
First name
Cell phone
Date (today)
|dd |mm |yyyy |
Last name
Personal email
Certificate Diploma Trades | part time full time
1. extend your accommodation within 1-14 weeks - prior to and/or after - a semester date, at the weekly rate
example: extend from April 24 to May 31 (weekly) for practicum
2. extend your accommodation beyond 14 weeks, at the semester and/or weekly rate
example: extend from December 20 to April 24 (weekly + semester)
Submit form directly to from your personal email. Extensions are subject to availability and
assignments sent via email. *If you are contracted for the academic year, do not provide an extension for Dec-Jan break*
Fall September to December 20
(1 semester, 16 wks) October 15
for spring extension
Spring January to April 24
(1 semester) February 15
for summer extension
Summer May to August 15
(1 semester) April 15
for fall extension
Academic year September to April 24
(2 semesters, 34 wks)
academic weeks are Sunday to Saturday | we do not do half weeks
Extend from (last day as per your License Agreement)
dd |mm |yyyy |
dd |mm |yyyy |
# of weeks
and/or +
# of semester(s)
Fall Spring Academic year Summer
1. I will clean my washroom, or arrange an alternating cleaning schedule with my washroom mate, on a
2. What is the only form of adhesive I can use on the walls in my room?
3. a) open alcohol is prohibited in lounges and on balconies, b) deep fryers are prohibited, c) marijuana storage is
permitted in a tightly sealed container but smoking or vaping it on housing grounds is prohibited - these are all?
true false
as per above weeks and/or semester(s)
Card Number
Name on Credit Card
Authorizing Signature
typed signature accepted
In making this application, I have personally read the contents in its entirety, and agree to the terms, conditions, and processes described within,
and that all of the information I have provided is correct. I acknowledge that residing on campus requires compliance with Housing policies. I
agree to conduct myself in alignment with the Community Standards and if unable to do so, agree to make alternate living arrangements.
Your Signature
Date of signing
|dd |mm |yyyy |
This information is collected for the purpose of securing accommodations at CNC. Your privacy is protected under the Freedom of Information and Privacy Act, limiting how your information may be
used or disclosed. Please contact the Freedom of Information Coordinator, College of New Caledonia, at 250 561 5828.