Fill - Free fillable Form 300: Applicant Information (Feather River Community College District) PDF form

Page: 1 of 10

FEATHER RIVER COLLEGE STUDENT HOUSING

300

GOLDEN EAGLE AVENUE, QUINCY, CALIFORNIA 95971

Applicant Information

Applicant Name: ______________

_______________________ Student ID#:_______________________________

Address: ________________________________

_____________________________________________________

City: __________________________________

_____ State: _______________ Zip: ________________

Home Phone: (_______) _______-___________

Cell Phone: (_______) _______-___________

Student Email: _________________________________ Parent Email: ________________________________

Birthdate: _______________________

____ Current Age: ________

(If under the age of 18, parent must sign all documents.)

Gender: ______ Male ______ Fem

ale

Are there any special ac

commodations or circumstances that you would like us to be aware of?

____________________________________________

__________________________________________________

Are there any medical

conditions that you would like us to be aware of?______________________________________

Medications taken regularly (please specify): __________________________________________________________

Emergency Contact Information

Name (First, Middle I

nitial, Last):_____________________________________________________________________

Address: __________________________

___________________________________________________________

City: ___________________________

_______ State: _____________ Zip: _____________

Home Phone: (_______) _______-_

__________ Cell Phone: (_______) _______-___________

Name of Insurance Carrier for

Applicant: _________________________ Policy/Group No._______________________

530-283-9414 

frchousing@frc.edu  www.frc.edu/housing

2020-2021 ACADEMIC YEAR

STUDENT HOUSING APPLICATION & LICENSE AGREEMENT

August 21, 2020 - May 22, 2021

Returning Students: Dorm applications will not be accepted if there is a past due balance on the account

Page: 2 of 10

Student Status

Check all that appl

1st Time Student Returning Student Student Athlete (specify sport):__________________________

My intended major or pr

ogram of study is:______________________________________________________________

Roommate Questionnaire

My roommate preference(s)

is: ______________________________________________________________________

Check one per question:

Sleep Schedule----- I cons

ider myself a: _____ Morning Person _____ Combination _____ Night Owl

Cleanliness----- I keep my

room: _____ Neat _____ Slightly Messy _____ Very Messy

Socializing----- I lik

e to go out with friends at night: _____ Weeknights and Weekends _____ Week-ends Only _____Hardly Ever or Never

Study Habits---- I pref

er to study: _____Outside my room (i.e. library) _____Quietly in my room _____ With music, TV, etc. in my room

Housing Site Preference:

Apartment Style Dorms (on-campus) The Pines (males only) Meadows Apartments

Room Preference: Mark your 1

and 2

choice below. Housing staff will make every effort to honor your

request.

One Bedroom / Double Occupancy (2 students)

Two Bedroom / Double Occupancy

(4 students)

Housing Fees:

$50

Application Fee

(Mandatory)

Non-refundable fee to be submitted with the application.

$400

Security/Cleaning Deposit

(Mandatory)

Due at the time of move-in for all residents. Financial Aid funds are

not available to pay this deposit.

$25/semester

$50/year

Activity Fee

$25.00 per semester for events and activities for the education and

enjoyment of all dorm residents.

$25/semester

$40/year

Parking Permit

Permit is required to park your vehicle on Student Housing property.

The permit must be displayed on the driver’s side windshield. Parking

regulations enforced by the first week of school; fines will be levied for

vehicles without permits.

Page: 3 of 10

Housing Payment Options:

Rent is calculated according to the acadmeic calendar, not the number of days in the month that the room is occupied.

For your convenience, there are four options to pay rent. Check the payment plan you intend to use; plans may be

changed by contacting the Student Accounts Technician. Approved payment methods include cash, check, Visa or

MasterCard or Financial Aid. Payments can be made in person, by electronic payment via MyFRC, or by phone at

530-283-0202, ext. 292.

Plan 1: Payment in full; must be submitted prior to occupancy or move-in. If payment is not received by the due

date, you will default to the monthly payment plan (Plan 3). Contact Student Accounts to change plans if

this obligation cannot be met. This plan cannot be chosen if Financial Aid is planned to be used to pay for

housing.

One Bedroom $4853

Due by 8/21/20

Two Bedroom $4542

Plan 2: Semester payments; must be submitted prior to occupancy or move-in each semester. This plan includes

an annual handling fee up to a total of $153. If payment is not received by the due date, you will default to

the monthly payment plan (Plan3). Contact Student Accounts to change plans if

this obligation cannot be

met. This plan cannot be chosen if Financial Aid is planned to be used to pay for housing.

One Bedroom

$2,503

Fall 2020 – due by 8/21/20

$2,503 Spring 2021 – due by 1/15/21

Two Bedroom

$2,347

Fall 2020 – due by 8/21/20

$2,347 Spring 2021 – due by 1/15/21

Plan 3: Monthly Installments; the first month’s payment to be submitted prior to occupancy or move-in.

Subsequent payments must be submitted by the deadlines listed below. This plan includes an annual

handling fee up to a total of $258. If payment is not received within five days of the due date, a $20 late fee

will be assessed. This plan cannot be chosen if Financial Aid is planned to be used to pay for housing.

Due

8/21

Due

9/1

Due

10/1

Due

11/1

Due

12/1

Due

1/1

Due

2/1

Due

3/1

Due

4/1

Due

5/1

One

Bedroom

$510 $510 $510 $510 $510 $510 $510 $510 $510 $510

Two

Bedroom

$480 $480 $480 $480 $480 $480 $480 $480 $480 $480

Page: 4 of 10

Plan 4: Financial Aid by semester; requires the Financial Aid Payment Form (page 8) to be submitted prior to

One Bedroom

$2,503

Fall 2020 - check with Financial Aid for your disbursement dates

$2,503 Spring 2021 – check with Financial Aid for your disbursement dates

Two Bedroom

$2,347

Fall 2020 – check with Financial Aid for your disbursement dates

$2,347 Spring 2021 – check with Financial Aid for your disbursement dates

Your initial verifies that you have read, understand, and agree with the section. All sections must be agreed to in order for

the District to accept the Student Housing Application and License Agreement.

I. OCCUPANCY

(a) Feather River College Student Housing (FRCSH) hereby grants to Licensee permission to occupy a bed space within a specific housing unit to

be assigned and identified by FRCSH for the 2020-21 academic year housing period, unless sooner terminated under provisions of this License

Agreement. Specific assignment of a housing unit shall be made by FRCSH and may be changed by FRCSH based on needs and circumstances as

determined by FRCSH, such as facility repairs or roommate conflicts. Initial: _____

II. ENHANCEMENT OF EDUCATIONAL EXPERIENCE

(a) Feather River College Student Housing shall maintain a professional staff to work with students to develop a community concept within the

housing facility to enhance student's educational experience at Feather River College. Feather River College Student Housing shall provide

opportunity for input by Licensee into the development of the community. The facility shall be operated to enhance the educational, social, and

recreational opportunities available to Licensee.

(b) Licensee agrees to recognize the importance of maintaining the housing facility as an environment that is conducive for fellow students to study,

live, and sleep. While in the facility, Licensee agrees to not disturb this environment and follow all rules set forth in the FRC Student Housing

Handbook and License Agreement. Initial: _____

III. TERMS AND CONDITIONS

(a) The FRC Student Housing Handbook is made a part of this License Agreement and residents are subject to all regulations contained in FRC

Student Housing Handbook, a copy of which has been provided for review and is available at the Feather River College Student Housing Office, on

the FRC website, and is provided at move-in.

(b) Licensee agrees to comply with the housing facility regulations, which are listed in the Student Housing Handbook, and any subsequent

amendments.

(d) It is understood and agreed by Licensee and Feather River College Student Housing that no lease or any other interest in real property is created

by this Agreement.

(e) Licensee agrees not to sublease a room to which he or she is assigned and to pay current and future housing rates of their assigned living

environment.

(f) Feather River College Student Housing reserves the right to change room rates and occupancy after due notice and to add other requirements

and stipulations as may become necessary for the betterment of the housing program and the general welfare of the students.

(g) To be eligible for occupancy, Licensee must be currently enrolled and maintain status as a student at Feather River College with at least 6

semester units. Initial: _____

Student Housing License Agreement

Initial: ____

occupancy or move-in. Financial Aid funds are not available to pay the Security/Cleaning Deposit. Students

using this plan must personally follow-up with the Financial Aid staff every couple of weeks to check the

status until their funds have all disbursed. Students are responsible for paying any balance remaining once

all financial aid has been disbursed. If the balance owed is not paid by the 10

week of the semester, a $20

late fee will be assessed monthly until the balance due is paid in full. This plan includes an annual handling

fee up to a total of $153. Contact Student Accounts to change plans if this obligation cannot be met.

Out-of-State Students: The PELL grant does not provide the funds to pay the full price of tuition and

housing; therefore, if y

ou are using Plan 4 it is required that you apply for a student loan to cover the balance

owed.

I have read and understand my payment due dates.

Page: 5 of 10

IV. MAINTENANCE OF PR

EMISES

(a) Feather River College Student Housing shall provide Licensee with the furnishings and in the condition noted on the Room Condition Inventory

(available upon check-in). Licensee agrees to give reasonable care to her/his living unit and its furnishings and to make payment for any damage or

loss promptly upon demand by Feather River College Student Housing. Licensee shall vacate the living unit in good order and repair; normal and

reasonable wear and tear accepted. In the event Licensee fails to maintain the living unit in good order and repair, Licensee shall pay Feather River

College Student Housing the reasonable costs incurred in returning the living unit to a condition of good order and repair. The Licensee will be

charged a security/cleaning fee according to a checklist of assessed damages and cleaning needs.

(b) Licensee shall make no alterations to the housing facility without the permission of Feather River College Student Housing. Any structural

addition or alteration is prohibited without written permission of Feather River College Student Housing Management.

(c) Licensee shall not possess any highly flammable material, firearm, ammunition, fireworks, explosives, dangerous weapons or any other material

or instrument which, in the opinion of Feather River College Student Housing authorities, poses an unreasonable risk of fire, damage or injury.

(d) Feather River College Student Housing shall not be responsible for any damages or losses that may occur in roads, driveways, parking lots or

parking areas.

Initial: _____

V. CANCELLATION BY LICENSEE PRIOR TO ACADEMIC YEAR FEE PERIOD

(a) Licensee may cancel their license after it has been approved by FRCSH by giving written notice to Feather River College Student Housing Office

at least 30 days prior to the beginning of the 2020-21 academic year fee period.

(b) A request to cancel a license less than 30 days prior to the beginning of the 2020-21 academic year fee period shall include Licensee's statement

of reasons. Feather River College Student Housing Management shall grant the request based on the following standards, with appropriate

verification: (1) end of student status, (2) marriage or (3) military duty. Feather River College Student Housing Management may grant, at its sole

discretion, the request based on the following standards, with appropriate verification: (1) extreme hardship beyond the control of licensee and (2) a

suitable replacement licensee is available to fill the vacated space. FRCSH shall make a reasonable effort to locate a suitable replacement licensee.

Initial: _____

VI. CANCE

LLATION AFTER THE BEGINNING OF THE ACADEMIC YEAR FEE PERIOD

(a) Licensee who requests to vacate the housing facility shall give at least a 30-day written notice of intention to vacate and the reason thereof. A

petition to terminate shall be obtained from Feather River College Student Housing Office, completed, and returned to the Student Housing Manager.

(b) Feather River College Student Housing Management shall grant a request to vacate submitted pursuant to subsection (a). The determination will

be based on the following standards, with appropriate verification: (1) graduation, (2) marriage or (3) military duty.

(c) Feather River College Student Housing Management may, at its sole discretion and on occasion, grant the request based on the following

standards, with appropriate verification of: (1) extreme hardship beyond the control of licensee and (2) a suitable replacement licensee is available to

fill the vacated space. FRCSH shall make a reasonable effort to locate a suitable replacement licensee.

(d) If request for cancellation is approved, Licensee’s financial obligation will be prorated by a daily rate for the dates of occupancy. The

security/cleaning deposit may be applied by the DISTRICT toward reimbursement for any cost incurred including (1) unpaid rent, (2) cleaning

expenses (3) repairs for room damage (will be based on current replacement and/or repair costs), (4) replacement of other items including lost or

damaged keys, equipment or furnishings. The $400.00 Security Deposit will otherwise be refunded. Initial:______

VII. REVOCATION OF LICENSE AGREEMENT

(a) Feather River College Student Housing Management may revoke this License Agreement and evict the Licensee upon the following conditions:

(1) Serious or repeated failure to comply with housing policies and procedures as stated in the License Agreement or Student Housing Handbook. If

a resident is asked to vacate the housing facility as a result of disciplinary action as defined in the Student Housing Handbook, FRCSH expressly

reserves the right to charge for the full academic year according to the License Agreement. All such failures are considered “non-curable” breaches

of the Agreement with the exception of payment or fees.

(2) Failure of Licensee to maintain status as a student at Feather River College and housing space is needed for other students.

(3) Licensee's serious or repeated breach of any term or condition of this License Agreement or the Student Housing Handbook (“non-curable”)

including failure to pay required payments and fees (“curable”).

(4) Licensee engaging in conduct that endangers the

safety or well-being of other residents, as reasonably known by management, or the conviction

of a felony.

(5) Administrative necessity (for example: facility repairs, safety or emergency) as determined by the Student Housing Management.

(b) FRCSH Management shall provide notice to Licensee not less than 72 hours prior to revocation of license resulting from an occurrence described

in subsections above, except in cases of emergency, such as (4) or (5). In the event a license is revoked, the security/cleaning deposit will be

applied as described above. Initial:_____

VIII. ABANDONMENT OR TERMINATION BY LICENSEE

Except as permitted in Section V or VI, termination of this License Agreement or abandonment of the premises by Licensee shall not release

Licensee from paying any obligation due Feather River College Student Housing. Under certain circumstances, revocation, termination or

abandonment, Licensee may be released from this agreement if a suitable replacement occupant is found, upon approval of Student Housing

Management. FRCSH shall make a reasonable effort to locate a suitable replacement licensee. Licensee’s personal belongings left on property will

be disposed of in accordance with legal requirements. Initial:_____

Page: 6 of 10

IX. DESTRUCTION OR UNAVAILABILITY

In the event that bed space

is destroyed or becomes unavailable as the result of conditions not reasonably foreseen at the time this License

Agreement is made, Licensee shall be entitled to a prorated refund of any fees applicable to periods after Licensee was required to vacate. Such

conditions include, but are not limited to, damage caused by floods, slides, fire, earthquake, other natural disasters, and vandalism; civil disorder;

compliance with state or federal law; unanticipated interruption of basic services; drop in the rate of vacancies or cancellations not reasonably

foreseen by FRCSH if such drop results in an over-booking of available housing facilities. Initial: _____

X. REFUND OF PAYMENTS

Feather Riv

er College Student Housing shall authorize refunds of payments only as provided for in the License Agreement and Student Housing

Handbook. Initial: _____

XI. VACATING THE HOUSING FACILITY

Licensee shall promptly vacate the housing facility on the expiration of the fee period or upon revocation of this License Agreement, whichever

occurs first, after due notice and in accordance with license agreement and legal requirements. Student housing facilities are closed during winter

recess when the rest of the campus is closed for an extended period of time (normally December 24-January 1 but consult district calendar for

exact dates). Residents must make alternate housing arrangements during this time.

Initial: _____

XII. PAYMENT PROCEDURE

(a) Payments are due in accordance w

ith the payment plan chosen by the resident.

(b) If payment is not received within five days of the due date, a $20 late fee will be assessed monthly until the balance due has been paid in full.

Initial: _____

XIII. TREATMENT OF INDEBTED

NESS

Failure of Licensee to satisfy the financial obligations of this License Agreement may result in action by the FRCSH, including but not limited to:

(a) Assessment of a late fee, in accordance with the fee schedule.

(b) Revocation of the License Agreement.

(d) Withholding of Feather River College services or records pursuant to the License Agreement and Student Housing Contract.

This includes: 1) Withholding official Feather River College transcripts / records. 2) Denial of registration.

(e) Offset of loans, grants, scholarships, and/or earnings payable through Feather River College.

(f) Referral to an outside collection agency, and/or a credit reporting agency; and/or legal action.

(g) Submission of your debt information to the Franchise Tax Board for possible deduction of payment from your tax refunds or other money the

state may owe you.

(h) Licensee agrees to pay all costs incurred by the Feather River College Student Housing to effect collection in the event of Licensee’s default.

(i) Licensee authorizes Feather River College Student Housing, its agents, and any collections agency or legal counsel under their direction to

contact any individual, school, employer, doctor, or state/federal agency in order to substantiate information, including current address, relevant to

collection of this debt. Initial: _____

XIV. RIGHT OF ENTRY

Feather River

College Student Housing shall have the right to enter the premises occupied by licensee for the purposes of damage inspection,

emergency, health, safety, maintenance, administration of applicable rules and regulations, or for any other lawful purpose. Initial: _____

XV. INSURANCE

(a) During the period cov

ered by this License Agreement, Licensee is recommended to obtain health, accident and renter’s insurance.

(b) Feather River College Student Housing does not have insurance to cover the personal or property damage of Licensee. Therefore, FRCSH

highly recommends that Licensee obtain insurance, such as renter's, accident and health policies. The FRCSH assumes no responsibility for

licensee’s personal property. Initial: _____

XVI. VISITORS AND GUESTS

Licensee shall permit no visitors or guests to enter the housing facility except as permitted under the Student Housing Handbook and License

Agreement. Minors under the age of 18 must have parental supervision and must be checked-in at the Office, Security Office or RA office.

Overnight visitors must be checked in at the Office, Security Office or Resident Assistant (RA) office in accordance with the handbook.

Initial: _____

XVI. NON-WAIVER

The waiver by FRCSH of any br

each of a term or condition of this License Agreement shall not constitute a waiver of any other or subsequent

breach. Initial: _____

XVIII. SECURITY

While Student Housing Managem

ent makes an effort to provide safe and secure premises, Student Housing Management shall not be liable for

resident’s safety. Residents must take full responsibility for their individual safety and should behave accordingly and take appropriate precautions.

Examples might include walking in groups, walking on well lighted paths during evening hours, locking doors and windows, not sharing or loaning

room keys, not opening doors to strangers, etc. Initial: _____

Page: 7 of 10

XIX. RELEASE OF INFORMATION

I authorize FRCSH to discuss my payments, academic standards, and /or behavior with my parents, guardians, or payee, as needed, if it will have

an effect on my financial commitments.

In the event of an emergency, illness, injury, or concern for safety and well-being, I authorize FRCSH to contact my emergency contact, parents,

guardians, or payee and/or if deemed necessary, the paramedics and allow them to transport me to a local hospital by ambulance for appropriate

medical care.

Initial: _____

ACKNOWLEDGEMENT:

This 2020-21 Student Housing License Agreement is entered into between Feather River College Student Housing hereinafter called

"FRCSH" and the Student Housing Applicant hereinafter called "Licensee.” THIS LICENSE AGREEMENT IS A CONTRACT FOR THE ENTIRE

2020-21

ACADEMIC YEAR. In consideration for the right to occupy an assigned space within the Feather River College Student Housing

facility, the signature of the Licensee hereby certifies that they have read, understand and agree to comply with all terms, dates, conditions,

policies, and procedures of the Student Housing License Agreement and FRC Student Housing Handbook, and agree to make payments to

FRCSH in accordance with one of the payment plans. If the Licensee and FRCSH jointly execute a License Agreement after the beginning of

the fee period, standard fees will be charged on a prorated basis for the balance of the academic year. The fee period is defined as the

2020-21

academic year period.

Student Housing Applicant (print): _____________________________________________________________________________________

Signed _________________________________________________________ Date:___________________________________________

Parent/Guardian Name (print): __________________________________________________________________________________________

Signed: ________________________________________________________ Date: __________________________________________

(Parent or Guardian for student under 18 years of age)

Return of the:

• Signed copy of this Application/License Agreement,

• $50 non-refundable application fee (we accept cash, Visa, MasterCard or check - make check payable to Feather River College),

• Guarantor Agreement, and

• Photocopy of Applicant's and Guarantor's Driver’s License or Photo ID

=============================================================

=============================

For Office Use:

Signed Student Housing License Agreement

$50 Application Fee

Guarantor Agreement

Photocopy of Applicant’s and Guarantor's Driver’s License or Photo ID

This Student Housing License Agreement is hereby accepted by the Feather River College Student Housing Office.

Signed: ____________________________________________ Date: _____________________________________________

shall constitute acceptance of the Student Housing Application/License Agreement by the student and parents/guardian/legally

responsible person if the student is under 18 years of age. The application is considered accepted once the complete Application/License

Agreement, application fee, and required documents have been received.

Send completed Application/License Agreement to:

Email to: studenthousing@frc.edu

FRC Student Housing

300 Golden Eagle Avenue

Quincy, CA 95971

Page: 8 of 10

Feather River College Student Housing

300 Golden Eagle Ave

Quincy CA 95971

530-283-0202 ext. 414

530-283-9289 – FAX

Applicant

Signature:_____________________________________________________________ Date:_______________________

FOR OFFICE USE ONLY:

Copy to Financial Aid Office: ____________________________________

(date)

Copy to Student Accounts Office: ________________________________

(date)

Financial Aid Payment Form

For FRC Student Housing Payment Plan #4

(This plan can NOT be used to pay for the application fee, security deposit, activity fee, or parking)

Applicant Name:___________________________________________________________________________________

Student ID#:_____________________________

Date 2020-2021 FAFSA completed:___________________________________

Does your FAFSA have the FRC School Code of 008597 on it? _____ YES ______ NO

Please read and initial the following:

______ I understand that my Financial Aid, which may include student loans, will first be used to pay my enrollment fees

then my housing fees.

______ I understand that by dropping or adding classes my Financial Aid Award WILL be affected and that I need to go

see Financial Aid to ensure my enrollment and housing fees are paid.

______ I understand that I am obligated to pay from other sources if my Financial Aid Award does not cover all of my

Housing Fees.

______ I understand that I am responsible to follow up frequently with Financial Aid to check the status of my file and to be sure

that my aid can disburse into my student account.

______ Out of State Students: I understand that the PELL grant does not provide the funds to pay the full price of tuition and

housing and that I am required to apply for a student loan to cover the balance owed.

Page: 9 of 10

FEATHER RIVER COLLEGE STUDENT HOUSING

GUARANTOR / PRIMARY OBLIGOR AGREEMENT

(GUARANTEE OF 2020-21 ACADEMIC YEAR

STUDENT HOUSING LICENSE AGREEMENT)

Unless released in wr

iting by Owner, Guarantor expressly acknowledges that he will be and remain jointly and

severally liable as a primary obligor for the terms and indebtedness hereunder and expressly acknowledges the

reliance hereon of the Owner.

Guarantor hereby expr

essly and irrevocably waives any right to assert against Owner any defense (legal or equitable),

subrogation, set-off, counterclaim or other right.

In regard to this Guarantor/Primary Obligor Agreement, the Guarantor/Primary Obligor must be a relative or

family friend over 25 years of age.

In consideration of the execution of the 2020-21 Academic Year Student Housing License Agreement for

Feather River College Student Housing located in Quincy, California, by and between

________________________________________ (Resident) and Feather River College Student Housing, hereby

known as Owner, and signed on Page 7 of the Student Housing Application & License Agreement by Resident on

___________________(date); ________________________________________ (Guarantor / Primary Obligor of

Resident), hereby known as Guarantor, does hereby jointly and severally guarantee unconditionally to Owner,

Owner’s Agent and/or Owner’s successor and assigns, the prompt performance of all terms, covenants and

obligations and payment by Resident or Guarantor of the payment and any other sums which become due pursuant to

the Student Housing License Agreement, including any and all court costs or attorney’s fees incurred in enforcing the

Student Housing License Agreement.

Guarantor warrants and represents that he will benefit directly or indirectly from Resident’s acceptance of the Student

Housing License Agreement and acknowledges that such represents full and complete consideration herein.

In the event of any breach of any terms of the Student Housing License Agreement or the Student Housing Handbook

by Resident, Guarantor shall be jointly and severally liable for any damages, financial or physical, caused by

Resident, including any legal fees incurred in enforcing the Student Housing License Agreement, the Student Housing

Handbook or this Guarantee. Guarantor shall have no longer than fifteen (15) days to make full payment of such

amounts that are due.

This Guarantee may be immediately enforced by Owner or Owner’s Agent upon any default by Resident and an

action against Guarantor may be brought at any time without first seeking any recourse against Resident.

The insolvency of Resident or nonpayment of any sums due from Resident will be deemed as default giving rise to

action by Owner or Owner’s agent against Guarantor.

If any legal action or other proceeding is brought by Owner to enforce any part of the Student Housing License

Agreement, Student Housing Handbook or this Guarantee, Owner shall be entitled to be reimbursed for reasonable

attorney’s fees and costs incurred from Resident or Guarantor.

This guarantee does not confer a right to possession of the premises by Guarantor, and Owner is not required to serve

Guarantor with any notices to terminate or to perform covenants, including any demand for payments or any action or

proceeding against Resident, prior to Owner proceeding against Guarantor’s obligation under this Guarantee.

Page: 10 of 10

If Owner or Ow

ner’s Agent contacts Guarantor for any violations by Resident it is agreed that it is in the best interest

for all parties that the Guarantor ensures that the Resident complies with Student Housing disciplinary actions.

However, Owner is NOT obligated to inform or discuss with Guarantor any situation regarding the Resident.

GUARANTOR / PRIM

ARY OBLIGOR:

Name of Guar

antor / Primary Obligor: _________________________________

Date of Bir

th: _____________________________________________________

Address: ______________

___________________________________________

City, State

, ZIP: ___________________________________________________

Social Security #: _________________________________________________

Driver’s L

icense # and State:_________________________________________

Home Phone: ___________________

__________________________________

Work Phone: ___________

__________________________________________

Employer’s N

ame: _________________________________________________

Employer’s A

ddress, _______________________________________________

City, State

, ZIP: ___________________________________________________

Your Position or Job: _______________________________________________

Supervisor’

s Name: ________________________________________________

Student Resident’s Name: ___________________________________________

Guarantor’s

relationship to Resident:___________________________________

PLEASE INCLUDE A CLEAR PHOTO COPY OF GUARANTOR’S DRIVER’S LICENSE

I verify t

hat all information given above is true and correct and authorize Owner to verify any information provided to

obtain all relevant credit information. By signing this agreement I give Owner the right to obtain a credit report and

employment verification and I accept all terms listed and within this Agreement.

I accept this

Guarantee and Agreement:

Guarantor / Primary Obligor Signature: ______________________________Date:______________

Owner’s Agen

t: _________________________________________________Date: _____________

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