Summer Housing Application 2022

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I Am* This field is required.

Muhlenberg Student

Non-Muhlenberg Student

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First Name* This field is required.

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Last Name* This field is required.

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Email* This field is required.

example@example.com

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Berg ID #

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Campus Address

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Muhlenberg Mailbox #

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Class Year

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Phone Number * This field is required.

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Reason for application* This field is required.

Local employment/internship for course credit or sponsored by campus department (PROVIDE DATES ON NEXT PAGE)

Research (PROVIDE DATES ON NEXT PAGE)

Campus Employment (PROVIDE DATES ON NEXT PAGE)

Summer Study (PROVIDE SESSIONS ON NEXT PAGE)

Extenuating family and/or home request- to be reviewed on an individual basis (PROVIDE SESSIONS ON NEXT PAGE)

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Move In/Out Dates* This field is required.Please list your requested move in/out dates- NOT the dates that you start/end work or rehearsal

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Extenuating CircumstancesYou can fill out the details in the form below or if you would prefer to talk to a specific resource on campus to provide context for your request, there is a list of resources below. You can call or email these resources by Wednesday, August 5. Michele Paules- michelepaules@muhlenberg.edu 484-664-3803 Robin Riley-Casey- robinriley-casey@muhlenberg.edu 484-664-3228 Courtney Stephens- courtneystephens@muhlenberg.edu 484-664-3180 Please still submit the form so that we have your request on file, but you do not need to include details in the form.

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Number of Days

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Please select session(s)All Summer Study housing residents are required to pay a weekly housing rate)

Summer Session 1 (6 weeks)

Summer Session 2 (6 weeks)

Science/Art Session 1 (4 weeks)

Science/Art Session 2 (4 weeks)

10 Week Summer Session

Summer 1 & 2 Sessions (12 weeks)

Science/Art Session 1 & 2 (8 weeks)

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Is the cost of housing included in your research approval?

Yes

No (You will be charged a weekly rate for your housing)

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Are you working at least 30 hours a week?

YESNO

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What department OR local employment are you working for?

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Who is your summer supervisor?

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Other Reason for Staying on Campus this summer

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Roommate Preference(s) (enter name)

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If a single room is available would you prefer it** : **Singles can not be guaranteed and are unlikely without an ADA qualifying documented special need.

YESNO

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**Singles can not be guaranteed and are unlikely without an ADA qualifying documented special need.If you receive a single room, you will receive an updated bill with single rate.

I understand

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If there are apartments available for the summer in 2201 Chew Street (you would be required to fill with 4 people in 2 doubles, so singles would not be available) would you be interested in this instead of East Hall?

YESNO

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Who are the 3 people you would live with?

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Lease Agreement* This field is required.In applying for summer housing, it is my understanding that I am leasing a space in a Muhlenberg College Residence Hall. https://www.muhlenberg.edu/media/contentassets/pdf/about/deanst/studentguide/Housing%20Lease.pdf

I agree to be bound by all regulations established by Muhlenberg College, including those established in the Student Handbook and the College Housing Lease.

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Housing Costs:

AFTER CLICKING SUBMIT, YOU WILL BE TAKEN TO A PAYMENT PORTAL TO MAKE A PAYMENT FOR YOUR ROOM COST (IF APPLICABLE). IF YOU CHOOSE NOT TO PAY YOUR ROOM CHARGE NOW, YOU MUST PAY PRIOR TO MAY 6TH FOR FIRST SESSION AND BY JUNE 10TH FOR THE SECOND SESSION.

ROOM CHARGE: ${total}

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total

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I would like to pay* This field is required.

My total today

My total before the May 6th deadline

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Payment

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Due Today: ${payment}