Oce Use Only Deposit
Student # Room Assignment
A $300 room deposit must accompany this application.
This application is for: Fall 20 Spring 20
Date of Birth Age
Sex Are you interested in gender-inclusive housing?
Yes No No Preference
City State Zip
Your Email Address
Phone Number(s)
Major College Classification: Freshman Sophomore
Please make your FIRST choice with a “1” and your SECOND choice with a “2”.
We will do our best to match your selection. All rooms are assigned on a first-come, first-serve basis.
THE BROWN COMPLEX (Traditional Style)
Wi-Fi, utilities and satellite TV in commons area included in price. Includes a choice of meal plans.
1 Bedroom (double) $2,884/per semester/ w/one roommate + 19 meals/week meal plan
1 Bedroom (double) $2,776/per semester/ w/one roommate + 14 meals/week meal plan
1 Bedroom (double) $2,656/per semester/ w/one roommate + 10 meals/week meal plan
Wi-Fi and utilities included in price. Meal plans available for purchase separately.
1 Bedroom Apartment $2,504/per semester/per student – w/one roommate
1 Bedroom Apartment $3,827/per semester/per student no roommate
2 Bedroom Apartment $2,231/per semester/per student - 2 students per bedroom
2 Bedroom Apartment $3,380/per semester/per student – individual bedroom
Select one only.
19 meals/week plan = $1,614/semester
14 meals/week plan = $1,506/semester
10 meals/week plan = $1,386/semester
No meal plan needed
*2020-2021 School-Year
Are you a member of a Crowder Athletic Team? Yes No
Soccer Basketball Baseball Softball Esports
Are you a member of the CAMP Program?
Yes No
Please indicate roommate preference here
Your name and phone # may be released to your new roommate(s) before move-in.
Crowder College complies with the Americans with Disabilities Act. If you need accommodations due to a
documented disability, please contact the Campus Life Office at 455-5644 for housing accommodations. For
academic accommodations in the classroom, please contact the Office of Accessibility Services at 455-5624
or 455-5433. If you will require assistance to evacuate during drills or emergencies, please provide details.
The $300 deposit will be held as security to cover any unpaid housing charges and room damages. If the
contract is completed, proper check-out procedures are followed and all outstanding charges are paid,
$250 of the deposit will be refunded (the remaining $50 of the deposit will be used to cover basic
administrative costs). Move-out prior to May will result in the loss of your deposit. Outstanding charges
include any balance owed to Crowder College. I voluntarily agree to live in the residence halls in accordance
with all terms, conditions, and regulations established by the college and in accordance with any new
regulations which may be established by the college. Rooms are available on a first come, first serve basis.
No rooms will be reserved without a deposit.
Student Signature
Parent/Guardian Signature (If under 18yrs)
Please return applications to: Campus Life, 601 Laclede Ave., Neosho, MO 64850
If you have any questions, please feel free to contact our office.
Crowder College Campus Life Office | 417.455.5644 | CampusLife@Crowder.edu
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In compliance with the Campus Security Act as amended in 1993, Crowder College is committed to providing
a safe campus for students and employees. Specifically, Crowder College is committed to building policies the
discourage students, employees, and visitors from violating federal, state, and municipal laws and avoid activities
that pose potential risk or threaten the health and safety of general campus community.
Due to concerns with campus safety and security, it is important for the Campus Life Office to know if you
have been convicted or have charges currently pending for a felony offense or disciplinary action (suspension,
expulsion, probation or warning) from a prior college or university. Permission for residents requesting to live
in the residence halls with a felony conviction or prior disciplinary action will be determined on a case-by-case
basis, dependent upon the circumstances of the conviction or severity of prior incidents. Failure to answer
the questions truthfully can result in judicial action including, but not limited to, immediate cancellation of an
individual’s housing contract. The College reserves the right to accept students into the resident halls.
Please answer the questions below.
Have you been convicted of a felony offense?
Yes No
Are there any charges currently pending against you in any jurisdiction or have you ever been convicted of,
or plead guilty to, any violation of law other than minor traffic violations? Yes No
Have you ever been administratively withdrawn, suspended, warned, placed on academic or disciplinary
probation, expelled, or requested or advised to resign from any post-secondary school? Yes No
If the answer to either of the questions is yes, give dates and complete details.
Student Acknowledgment Statement
By signing this application or transmitting it electronically, I agree to abide by the Residence Halls Code of
Conduct and all other rules and regulations of Crowder College. I understand that deliberate falsification and/or
omission of information pertaining to this application may result in immediate dismissal from the residence halls
or other disciplinary action. To the best of my knowledge, the above information is true and complete in
all respects and no important information has been withheld.
Print Name of Applicant
Student/Parent Signature
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