Fillable Residence Hall Application (Eastern New Mexico University)

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Residence Hall Application (Eastern New Mexico University)

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File type: PDF

U.S.A. forms for Eastern New Mexico University

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This is my first year at ENMU.
I am a returning student, and have already lived on campus.
Student Applicant Information
Legal name: Last: First: Middle:
Preferred name: Biological Sex: Male Female
Gender: Male Female Non-Binary
Birthdate: ENMU ID number:
Mailing address: City: State: ZIP:
Phone: Mobile phone: ENMU email:
Classification next term: Freshman Sophomore Junior Senior Graduate
Contract term requested: Fall 20 –Spring 20 Fall 20 only Spring 20 only
Residence Hall Preference
All residence halls are coed.
First choice: Curry Room type (choose one):
Double
Private
(check one) Guadalupe Room type (choose one):
Suite
Semiprivate suite
Eddy Room type (choose one):
Suite Semiprivate suite
Double
Private
Second choice:
Curry Room type (choose one):
Double
Private
(check one)
Guadalupe Room type (choose one):
Suite
Semiprivate suite
Eddy Room type (choose one): Suite
Semiprivate suite Double
Private
Third choice:
Curry Room type (choose one): Double
Private
(check one)
Guadalupe Room type (choose one):
Suite
Semiprivate suite
Eddy Room type (choose one):
Suite
Semiprivate suite
Double
Private
(There are limited number of privates, suites and semiprivate suites available. We do not guarantee a private, suite or semiprivate
suite room if you indicate such a preference. There is an additional charge for private rooms, suites and semiprivate suites. Double
rooms are assigned if no privates, suites or semiprivate suites are available.)
Meal Plan Information
Please indicate your Meal Plan choice: Carte Blanche Option 19
Option 14
Option 10
Residence Hall and Dining Services Agreement: The Residence Hall and Dining Services Agreement is a legal and binding agreement
between you and Eastern New Mexico University. Your signature indicates your commitment to pay for services for a academic year (fall
and spring semesters) or the remainder of the academic year if you enter into the agreement after the start of the fall semester. Application
for admission to the University and application for on-campus housing are separate processes, acted upon separately by the University.
Meal Plan Terms and Conditions: The meal plan requirement extends for the academic year. For specic meal plan requirements and
additional information, contact the Ofce of Housing and Residence Life at 575.562.2631. Per University Residence Policy, students living in
a residence hall are required to sign up for one of the four approved residence meal plans: Carte Blanche, Option 19, Option 14 or Option 10.
Meal Plan Refunds: Refunds will be processed based on tuition and fees refund schedule. After Aug. 31, no refunds will be allowed
unless a student ofcially withdraws from the University. Upon ofcial withdrawal and cancellation in writing to Housing and
Residence Life, refunds will be given on a weekly basis.
Residence Hall Application
Ofce of Housing and Residence Life
ENMU Station 39 | 1500 S Ave K | Portales, NM 88130
Phone: 575.562.2632 | Fax: 575.562.4321 | housing.ofce@enmu.edu
PN2392 • 4/20Residence Hall Application, Page 1 of 3
Assignment Preferences
The following information will be used for your roommate assignment. We will try to honor your stated preferences,
however, assignment preferences are limited to availability. Please choose one item for each category.
I am a: Smoker Nonsmoker
I prefer to live with a:
Smoker
Nonsmoker
No preference
I prefer going to sleep: Before 11 p.m. After 11 p.m.
I prefer to keep my room: Very neat Tidy Clean, but messy
I consider myself: Very social Social Reserved
I prefer a roommate who is:
Very social Social Reserved
I plan to study:
Often (3+ hours per day) Some (1–3 hours per day)
I prefer to study: In my room Elsewhere in my dorm In the library
I prefer to study with: Music/TV in background No music/TV
My musical preference is: Alternative Rock Classical Country
Gospel Hard rock Rap
Rock Soft rock/pop Soul
Other (please specify):
My special interests are: I am a member of the ENMU Athletics community. If so, what team:
Baseball Basketball Cross country
Football Rodeo
Soccer
Softball
Spirit squad Track & field
Volleyball
I am a member of the ENMU fine arts community. If so, what discipline:
Art
Communication Film
Music (band)
Music (choir) Theatre
Other (please specify):
I would like to room with an international student.
Yes
No
I plan to bring a computer that I would like connected to the campus network.
Yes
No
I have physical disabilities or other conditions requiring special housing consideration.
Yes
No
If yes, please indicate:
Roommate Request Information
If you are requesting a specic roommate, the Residence Hall Applications for both students should be submitted at
the same time if possible, and the request must be mutual.
Name of requested roommate:
Emergency Contact Information
Name: Relationship:
Daytime phone: Evening phone:
Do you have any medications or allergies?
Yes
No
Please list medications/allergies:
Additional comments:
PN2392 • 4/20Residence Hall Application, Page 2 of 3
Housing Deposit Payment Options
Do you want to charge the required $150 housing deposit to your student account?
Yes
No
If no, you do understand you must submit a $150 deposit so we can process your application?
Yes
No
Do you have an approved ESA/Service Animal through accessibility services?
Yes
No
If yes, would you like your $150 ESA/Service Animal Deposit charged to your student account?
Yes No
You can pay with a credit or debit card by phone at 575.562.2632 or you can mail your check or money order to:
Housing and Residence Life
ENMU Station 39
1500 S Ave K
Portales, NM 88130
Acknowledgement and Signature
I understand my $150 housing deposit will be refunded only if a written request for cancellation is received by: Aug. 1
for academic year (fall and spring semesters), Jan. 1 for spring only.
When I sign this application, I am agreeing to the terms and conditions of the Residence Hall and Dining Services
Agreement, to pay all room and board fees when due, to abide by all the rules, regulations and policies as outlined in
the Student Handbook, Guide to Campus Living, and supporting documents covering room and board accommodations
at Eastern New Mexico University. This agreement terminates at the end of the spring semester. Moving or checking
out of the residence hall does not constitute release from the agreement.
Applicant signature: Date:
Legal guardian signature required if housing applicant is 17 years old or younger.
Legal guardian signature: Date:
Family Educational Rights and Privacy Act (FERPA) Acknowledgement and Signature
I give permission for the following persons to have access to my housing information and records for (check all that apply):
Housing and meal plan charges
Disciplinary issues
Other (please indicate):
Name: First: Last:
Relationship to student applicant:
Name: First: Last:
Relationship to student applicant:
I understand that this permission form is applicable only for the Ofce of Housing and Residence Life and that it
expires at the end of the contract term noted above. I also understand that I must le a new permission form for each
school year. If I decide I no longer want permission given to those listed above, it is solely my responsibility to notify
the Ofce of Housing and Residence Life in writing. (Note: the ofces of Counseling and Career Services, Financial Aid,
Registrar, La Casa ENMU Student Health Services have their own specic information release forms.)
Applicant signature: Date:
PN2392 • 4/20Residence Hall Application, Page 3 of 3
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Residence Hall Application (Eastern New Mexico University)

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Completed 20 August 2020

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