Northeastern Oklahoma
A&M College
STUDENT HOUSING APPLICATION
I am applying for r Fall, August 20___ r Spring, January 20___ r Summer, June 20___
Applicant’s Name _________________________________________________________________________
Last First MI Sufx
Student ID Number _____________________________ Gender: Male r Female r
Permanent Address _________________________________________________________________________
Street City State Zip
CollegeClassication Freshmanr Sophomorer Major: ____________________________
BirthDateandAge _______/_______/_______ Age: __________
Contact Information __________________________________ ____________________________________
HomePhone CellPhone
Emergency Contact __________________________________ ____________________________________
Name Phone
Room Assignment Data Do you prefer a private room (Traditional Halls Only) Yes r No r
Whattypeofmusicdoyouprefer ______________________________________________
Are you a member of any organized NEO team ___________________________________
Requested Roommate(s) _____________________________________________________
Are you neat and organized Do you go to bed early Do you like to sleep late
Yes r No r Yes r No r Yes r No r
Haveyoueverbeenrequiredtoregisterasasexoffender(asanadult)?
Yes r No r
Ifyes,pleaseidentifytheyearandstateofyourregistrationandattachittothisapplication________________________
OFFICE USE ONLY
_____________________________________
DATE RECEIPT NO.
_____________________________________
C/ODATE STAFF
DEPOSIT:_____________________________
___ RE
FUND ___ APPLY
___ FORFEIT
Signature: _________________________________________________________Date: _________________________
Parent Guardian (if under 18): ________________________________________________________________________
HOUSING CHOICES Pleaseindicate1st,2ndand3rdchoice.
Traditional Female Halls: ___ Dobson Hall ___ Harrill Hall
TraditionalMaleHalls: ___VannHall ___RussellHall ___DyerHall(ScholarshipFootballonly)
Suite Style Housing (Co-Ed): ___ 4 Bedroom ___ 2 Bedroom
NEO Student Quad 1 ___ 2 Bedroom
NOTE:TheHousingdepositmustaccompanythisapplicationbeforehousingwillbereserved.Thedateofdepositwilldeterminethepriorityforassignmenttotheresidence
hallofyourchoice.Thedepositwillbeheldassecuritytocoveranyunpaidhousingchargesandroomdamages.Ifpropercheck-outprocedureisfollowedandalloutstanding
chargesarepaid,thedepositwillberefunded.Arefundrequestmustbereceivedwithinone(1)yearaftertheendofthelastenrollmentperiodthatthestudentwasahousing
residentinabsenceofatimelyrefundrequest,anysecuritybalanceshallbeconclusivelydeemedforfeitedtoNortheasternOklahomaA&MCollege.
MAIL TO: NEO Business Ofce 200 I Street NE Miami, OK 74354
A $75 Deposit required for traditional dorms | A $150.00 deposit required for NEO Suites and NEO Student
Quads.
A Mandatory $15 PO Box deposit is required (refundable upon Check-out)
* All deposits must accompany the application before room assignment is made.
*Will NOT be processed without deposit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome