Conference and Event Services - Summer Housing Application

Name

First NameLast Name

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Cell Phone

Format: (000) 000-0000.

Date of Birth

MonthDayYear

Email

example@example.com

I'm currently attending the following university/college

Please explain why you require summer housing (example: I am interning for Acme Corporation and am in need of short term housing)

My stay is Saint Elizabeth University affiliated

Would you prefer a single suite or single room?

Will you have a car on campus?

Please attach official documentation proving participation in non-CSE affiliated internship, or courses.

Company/Institution

University or College

Contact Name

First NameLast Name

Contact Phone Number

Format: (000) 000-0000.

Check here if documentation is not available at this time

Emergency Contact Information

Full Name

First NameLast Name

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Permanent Home Phone

Format: (000) 000-0000.

Cell Phone

Format: (000) 000-0000.

Email

example@example.com

Relationship

I will require Summer Housing for the following dates:

Arrival Date

MonthDayYear

Departure Date

MonthDayYear

In order to validate my request for accommodation:

*I hereby declare that the information I have provided in this application is accurate to the best of my knowledge.

*I also understand that I am responsible for the policies and procedures stipulated in the Summer Intern Housing Contract

Do you accept these terms?

Check the box and follow the instructions

If you are experiencing difficulties submitting this application, please call 973-290-4384.