Admissions - Undergraduate - Enrollment Process

Student Contact Information
Name*

First NameLast Name
Gender*
Type of Student*

FreshmanTransferInternational
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone
Cell Phone*
Email*
example@example.com
Class Year*

FreshmanSophomoreJuniorSenior
Birth Date*

MonthDayYear
Housing Preference

Incoming students are generally assigned to double room accommodations.
Room Preference*
I would like to room with:
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Survey Questions
1. What is your anticipated major?
2. When do you study?

MorningAfternoonEvening
3. What type of environment do you need when studying?

Completely QuietSome NoiseNo Preference
4. What time do you typically go to bed?

9 p.m. to 11 p.m.11 p.m. to 2 a.m.2 a.m. or later
5. What are your interests?

Talking on the phoneGoing out with friendsSurfing on the InternetReadingSportsListening to musicHanging out with friends at homeWatching TVOtherOther
6. Describe yourself.

OutgoingReserved
7. What type of music do you like?
8. Do you smoke?

YesNo
9. If yes, how often?

RarelySometimesOften
10. Would you mind being placed with a smoking resident?

YesNo
11. If you are a first-year student, which high school did you attend?
12. Would you prefer to live with a resident from your high school?

YesNo
13. What was your favorite high school activity or club?
14. How neat are you?

Extremely NeatModerately NeatNot Neat
15. Would you like the opportunity to live with an international student?

YesNo
16. If you are an international student, would you like the opportunity to live with an American student?

YesNo
17. How often do you plan to visit home?

RarelySometimesOften
18. Would you prefer to share items with your roommate (e.g. refrigerator, TV, cleaning supplies, etc.)?

YesNo
19. How often do you anticipate having guests?

RarelySometimesOften
20. Do you have any medical/health conditions that would affect your housing assignments?

YesNo
* If yes, you must contact Accessibility Services at (973) 290-4261 and speak with the Accessibility Services Coordinator regarding placement in housing.
Additional Comments
Emergency Contact Information
Parent/Guardian/Mentor Name:*

First NameLast Name
Day Phone:*
Evening Phone:*
Please provide us with an emergency contact (parent, family, mentor).
Contact Name:*

First NameLast Name
Relation to you:*
Day Phone:*
Evening Phone:*
Allergies/Medical Conditions:
Should be Empty: