UAS Housing Application Fall 2024 - Spring 2025
Family Housing Application
Legal Name
*
First Name
Last Name
Preferred Name
This is used for Housing purposes only. To update your preferred name, please visit UAOnline.
Student ID
*
Mobile Phone Number
*
Preferred Email
*
example@example.com
Gender Identity
*
Mailing Address
*
Age
*
Have you lived at UAS Housing before?
*
How many cumulative credits do you currently have?
*
This is NOT how many credits you are enrolled in for the upcoming semester, but how many credits from previous semesters you have.
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Emergency Contact
Emergency Contact Name
*
First Name
Last Name
Relation to Self
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Emergency Contact Email Address
*
example@example.com
Emergency Contact Address
*
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Missing Persons Contact Info
As per UAS Policy, all UAS Housing residents have the options to submit a Missing Persons Contact. This contact is separate from the Emergency Contact listed in your UAOnline account. The Missing Persons Contact is completely confidential. If you do not set up a Missing Persons Contact, in the case that you are determined missing, UAS will contact the Emergency Contact listed on your account. If you are under the age of 18 and not emancipated, UAS Housing will also contact your custodial parent or guardian within 24 hours of the time you are reported missing.
In the case that I go missing I would like UAS to:
*
Contact the Emergency Contact I have listed in UAOnline
Contact my Missing Persons Contact (if you are selecting this option, please fill out the boxes below
Full Name
First Name
Last Name
Relation to Self
Missing Persons Contact Mobile Number
Missing Persons Contact Email
example@example.com
Missing Persons Contact Address
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Allergen Information and Dietary Preferences
Do you have a dietary preference you would like to disclose?
*
Pescatarian
Vegertarian
Vegan
Gluten Free
Dairy Free (but not vegan)
Low Carb
Kosher
Halal
None
Other
Do you experience any of the following allergies? Select all that apply.
*
Milk
Eggs
Peanuts
Tree Nuts
Fish
Crustacean Fish
Wheat
Soy
None
If you have any other allergies or health conditions we should be aware of as we make a housing placement for you, please tell us a little more here:
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Housing Unit Type
Your placement preference will be considered but cannot be guaranteed due to space/requirement limitations. Provide a 1st and 2nd choice, if you desire.
First Choice
*
Flat Unit - $7,450/semester. Flat unit with full kitchen consisting of a microwave, stove, and refrigerator. Fully furnished living room with couches, dining room table, and chairs. Two bedrooms, each with two twin extra-long beds, two dressers, and two desks. Each apartment has a storage room in the entry way hook-ups for a washer and dryer if a resident chooses to provide those appliances on their own.
Townhouse Unit - $7,450/semester. Two-story unit with full kitchen consisting of a microwave, stove, and refrigerator. Fully furnished living room with couches, dining room table, and chairs. Two bedrooms, each with two twin extra-long beds, two dressers, and two desks. Each apartment has a storage room in the entry way hook-ups for a washer and dryer if a resident chooses to provide those appliances on their own. Townhouse-style apartments also have storage underneath the stairs.
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Meal Plans
Family housing students are not required to purchase a meal plan, but can if they choose. Meal plans at UAS can be used at two campus locations: the Lakeside Grill and Market, and Spike's Cafe. Meal plans can also be used across campus at campus-based vending machines. All meal plans are declining balance - that is, each dollar charged to your meal plan is used as a dollar at a dining location. UAS does not utilize all-you-can-eat meal swipes. Meal plans expire at the end of each semester. Any unused funds at the end of the semester will be removed from your meal plan and are non-refundable. Meal plans are financial aid eligible. As long as you have enough aid, your meal plan can be paid for with financial aid awards. Each meal plan is titled using the approximate number if meals per week the plan will cover, assuming an average cost if $11/meal.
Meal Plan Selection
4 Meal Plan - $750/semester. This meal plan is the equivalent to 4 meals per week or $6.50 per day
8 Meal Plan - $1,400/semester. This meal plan is the equivalent to 8 meals per week or $12 per day
11 Meal Plan - $2,050/semester. This meal plan is the equivalent to 11 meals per week or $18 per day
15 Meal Plan - $2,700/semester. This meal plan is the equivalent to 15 meals per week or $23 per day
Meal Plan Exemption - I would not like to have a meal plan for the semester in which I am applying
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Dependents
Will a second individual live with you? (Dependent 1)
*
Yes
No
Will a third individual live with you? (Dependent 2)
*
Yes
No
Will a fourth individual live with you? (Dependent 3)
*
Yes
No
What is this person's relationship to you?
*
What is this person's relationship to you?
*
What is this person's relationship to you?
*
Dependent 1 First Name:
*
Dependent 2 First Name:
*
Dependent 3 First Name:
*
Dependent 1 Last Name:
*
Dependent 2 Last Name:
*
Dependent 3 Last Name:
*
Dependent 1 Gender
*
Dependent 2 Gender
*
Dependent 3 Gender
*
Dependent 1: Does this person presently have misdemeanor charges pending against them or have they been convicted of a misdemeanor in the past five years?
*
Yes
No
If yes, please disclose all charges.
Dependent 2: Does this person presently have misdemeanor charges pending against them or have they been convicted of a misdemeanor in the past five years?
*
Yes
No
If yes, please disclose all charges.
Dependent 3: Does this person presently have misdemeanor charges pending against them or have they been convicted of a misdemeanor in the past five years?
*
Yes
No
If yes, please disclose all charges.
Dependent 1: Does this person presently have felony charges pending against them or have they ever been convicted of a felony?
*
Yes
No
If yes, please disclose all charges.
Dependent 2: Does this person presently have felony charges pending against them or have they ever been convicted of a felony?
*
Yes
No
If yes, please disclose all charges.
Dependent 3: Does this person presently have felony charges pending against them or have they ever been convicted of a felony?
*
Yes
No
If yes, please disclose all charges.
Dependent 1: Does this person presently have sexual offense charges pending against them? Have they ever been charged or convicted of a sexual offense crime, or attempt to commit a crime, as defined by Title 11 of Alaska Statues?
*
Yes
No
If yes, please disclose all charges.
Dependent 2: Does this person presently have sexual offense charges pending against them? Have they ever been charged or convicted of a sexual offense crime, or attempt to commit a crime, as defined by Title 11 of Alaska Statues?
*
Yes
No
If yes, please disclose all charges.
Dependent 3: Does this person presently have sexual offense charges pending against them? Have they ever been charged or convicted of a sexual offense crime, or attempt to commit a crime, as defined by Title 11 of Alaska Statues?
*
Yes
No
If yes, please disclose all charges.
Dependent 1 Date of Birth
*
-
Month
-
Day
Year
Date
Dependent 2 Date of Birth
*
-
Month
-
Day
Year
Date
Dependent 3 Date of Birth
*
-
Month
-
Day
Year
Date
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Criminal History Disclosure
All applicants for Student Housing must disclose pending criminal charges, past criminal convictions, and consent to a criminal background check
Do you presently have felony charges pending against you or have you ever been convicted of a felony?
*
Yes
No
If yes, please disclose all charges.
Do you presently have misdemeanor charges pending against you or have you been convicted of a misdemeanor?
*
Yes
No
If yes, please disclose all charges.
Do you presently have sexual offense charges pending against you? Have you ever been charged or convicted of a sexual offense crime, or attempt to commit such a crime, as defined by the Title 11 of Alaska Statutes? The Alaska Statutes are available online at www.legis.state.ak.us/folhome.htm
*
Yes
No
If yes, please disclose all charges.
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I have read and understand the terms of this agreement. I understand this agreement to be a binding contract between the University of Alaska and myself. I show my acceptance and agree to comply with these terms by returning a signed copy of this agreement to the UAS Housing Office, 4300 University Dr. Juneau, AK 99801. I acknowledge that signing this agreement does not guarantee my placement in Housing.
Name
*
First Name
Last Name
Signature
*
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