Housing Check in

Housing Check-in Form
Student ID Number
Name

First NameLast Name
Birthdate

MonthDayYear
E-mail
Personal Email Address
Cell Phone Number

Area CodePhone Number
Parent/Emergency Contact Name

First NameLast Name
Relationship to Emergency Contact
Please do not list a coach or Southwestern Staff member who is not a relative.
Parent/Emergency Contact Cell Phone Number

Area CodePhone Number
Parent/Emergency Contact E-mail
example@example.com

Room Information
Building
Room Number
Room Key Number
Ex. 15-300
Outside Door Key Number (Cole Hall, Wallingford Hall, and the apartments do not have an outdoor key)
Ex. 8-181
Please note: There is a $50 replacement fee per door for lost room keys. There is a $300 replacement fee for lost outside entrance door keys.

Cole Hall and Wallingford Hall residents use their student ID cards for access to the outside entrance doors. There is a $10 replacement fee for student ID cards. See Student Accounts in the Christy administration Building for replacements.

Signature
If you have questions, please contact Residence Life at 620-229-6392 or 1-800-846-1543 ext. 6392 or residence.life@sckans.edu.
Should be Empty:

Housing Check-in Form