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Mansion Hill or University Park
Application for Housing

Instructions

1. All information must be completed for us to process your application.
2. The application fee is $25.00. Please submit the application fee to the Residential Life Office. Application will not be processed without application fee.

Personal Data
Date
Name
Address
(City, State, Zip)
Home Phone
Alternative Phone
Email Address
Birth Date
Gender
 Male  
Female  
Transgender/Transsexual      
Have you lived with us before?
 Yes                  
No
Emergency Information:
Parent/Guardian
Address
(City, State, Zip)
Phone
Emergency Contact
(other than Parent or Guardian)
Phone
University Standing & Information
Student Status

New
Current
Transfer
Class
 Freshman
Sophomore
Junior
Senior
Graduate
Major
Minor
UMSL Student ID No.
If not a UMSL student what school will you be attending?
  
(will be required to provide proof of enrollment each semester)
Room Preference
List choices, in order of preference in the boxes from 1 to 4
1 being your preferred choice
Mansion Hill 1 Bedroom (unfurnished)
Mansion Hill 1 Bedroom (inclusive)
Mansion Hill 2 Bedroom (unfurnished)
Mansion Hill 2 Bedroom (inclusive)
Mansion Hill 2 Bedroom (unfurnished) NO ROOMMATE
University Park 1 Bedroom

University Park 2 Bedroom
Contract Length
Applying for which Year and Semester?
Contract
Please select only one:

Fall Semester Only (August to December)
Spring Semester Only (January to May)
Academic Year (9 Months from August to May)
 12 Month Contract

Requested
Move In Date
Do you have a roommate in mind?
Roommate?
Theme Housing Communities
Community Choice
 Family
International
Transitional
Graduate Student
No Preference
Personal Traits
Please check
all that apply:
I am a smoker
I have allergies
I listen to loud music
I sleep late
I wake up early
I study frequently
I rarely study
I enjoy playing sports
I participate in Greek Life
I enjoy social activities
I am shy
I am outgoing
Additional Agreements
Meal Plan's Declining Balance

The University requires that all students living on
campus to purchase a meal plan. Meal plan for
Mansion Hill and University Park is a $200
Declining Balance for the semester. Declining
Balance is money that residents can use to
purchase items at any Chartwells location
on campus. No meal plan is required during
the summer semester.

*Any funds that are not used of the declining
balance portion of the meal plan will roll over
from Fall semester to Winter semester, but not
from one academic year to the next.  There are
no refunds on unused portions of the meal plan.

I hereby acknowledge that I was informed
of the meal plan and understand $200 will be
billed to my student account each semester
I reside in University Park or Mansion Hill.
University Meadows

We will attempt to honor all requests, but
cannot guarantee any preferences. NOTE:
You do have the option of alternative housing
with the University Meadows. Please check
the box below to acknowledge that you prefer
to reside with UMSL Residential Life.

I hereby acknowledge that I was informed
by UMSL of the option to reside at the
University Meadows Apartments, but choose
to reside with UMSL Residential Life.

Waiver

All students must be 21 years of age or older. The age requirement is waived for students with children, married students or students with 60 or more credit hours.

I hereby acknowledge that I meet the above requirements.

Additional Concerns?
Please state any additional concerns them here:
If you were referred by a FRIEND, please write their name here:
   

 

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