HOUSING APPLICATION ADDENDUM
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?
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Have you ever been administratively withdrawn, suspended, warned, placed on academic or disciplinary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
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