Application for Residence Hall Summer Session
Hampton University
Date
*
-
Month
-
Day
Year
Date
Prefix
*
Miss
Mrs.
Mr.
Student ID #
*
Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address (Mailing address prior to opening of Summer Session)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age
*
Field of study
*
Physical Disability
*
Yes
No
Describe if yes
Incase of emergency, who should be contacted?
*
Emergency Contact Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Relationship
*
Emergency Contact Telephone #
*
Please enter a valid phone number.
Have you ever been a resident student at Hampton University?
*
Yes
No
If so, when?
Do you have a choice of roommate?
*
Yes
No
If so, whom?
Do you smoke?
*
Yes
No
Current Status
*
Graduate Student
Undergraduate Student
Pre-College/Summer Bridge
Special (Non-HU Student)
Indicate Session(s) you plan to attend
*
Session I (May 24 - June 21, 2024)
Session II (June 10 - July 19, 2024)
Session III (June 24 - July 19, 2024)
Pre-College / Summer Bridge (June 14 - July 19, 2024)
8 Weeks Session (May 24 - July 19, 2024)
Submit
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