Pre-Arrival Check-in Form

Housing
Freshman and Sophomore Students, as well as international students coming directly from overseas, are required to live on campus, with exceptions. Please review our residency requirement in the Waldorf Catalog for further information.
Do you plan to live in on-campus or off-campus housing this year?*

On-campus - I know my housing assignment for this school yearOn-campus - I have not yet received my housing assignment.Off campus - I know where I will be living this school year.Off campus - I do not know where I will be living yet.

On Campus Address
What is your residence hall or theme house?*
What is your dorm number?
If you are in a theme house, please write not applicable or NA.

Off-Campus Housing Address

This is where you will live during your studies at Waldorf this year.
Address*

Street Address

Apartment Number

CityState / Province

Postal / Zip Code

Waldorf Laptop

All full-time students are entitled to the use of a Waldorf Laptop. Part-time students may request to rent one for a fee. All students will be required to return the laptop at the end of their time at Waldorf or they will be charged the cost of the laptop. The laptop is a Dell. Students will need to report to IT on the third floor of Salveson hall to pick up their Waldorf laptop when they have arrived to school, if they have requested one. **NOTE: any damage to Waldorf equipment will result in a replacement charge on your account**
Do you need a Waldorf laptop?*

I would like to have a Waldorf laptop, and I don't already have one.I have my own computer or a Waldorf laptop already.

Vehicle Registration

The following information must be completed to receive a parking permit on campus. All residential students are required to register their vehicles and purchase a parking permit to park in any Waldorf University student parking lot: Lot A, Lot B, Lot C, or Lot D (all traditional first-year students are assigned to Lot C). Students must purchase a new parking permit every year. Permits are $100 (paved lot) and $75 (unpaved lot) for the academic year or $75 (paved lot) and $50 (unpaved lot) for the spring semester. Parking fees are non-refundable after the first day of classes. The registration fee will be applied to the student's account in the Business Office. If a different vehicle is brought to campus, it must be registered within 24 hours and a new parking permit obtained through the Office of Student Life in the Campus Center. Additional permits are $5. Permits may be obtained between 9 a.m.-5 p.m., Monday-Friday. Once your registration is received, a parking permit will be placed in your student mailbox.
Will you be bringing your vehicle to Waldorf and need a parking pass?*

YesNo

Vehicle Registration Information

I request permission to operate/park a vehicle on campus while I am a student at Waldorf University.
Vehicle Year*
Vehicle Color*
Vehicle Make*
(eg. Chevy, Ford, Honda, etc.)
Vehicle Model*
License Plate Number*
State Issuing License Plate*
Please check every box stating that you understand each of the following statements.*

I hereby agree to review and follow the policies found in the Waldorf University Campus Parking Brochure. This brochure will be given to me upon check in at the CIC desk.I understand that when my vehicle is not in use, it must be parked in the assigned parking lot.I understand that my vehicle must be registered and identified by a parking permit displayed inside the rear window on the lower left, driver's side corner.I understand that Waldorf is not responsible for any damage, vandalism or theft of my vehicle or its contents while parked and/or operated on campus.By signing below, I acknowledge that I understand and accept the terms and conditions of obtaining a parking permit.

Emergency Contact Information
Emergency Contact #1 Name*

First NameLast Name
Contact #1 Relationship to Student*
Emergency Contact #1 Cell Number*
ex. 1-800-292-1903
Emergency Contact #1 Email*
Does your emergency contact #1 speak English?*

YesNo
Emergency Contact #2 Name

First NameLast Name
Contact #2 Relationship to Student
Emergency Contact #2 Cell Number
ex. 1-800-292-1903
Emergency Contact #2 Email
Does your emergency contact #2 speak English?

YesNo

English Speaking Emergency Contact

Please provide the contact information of someone that we can contact to help translate for your primary emergency contact or who can be informed instead of your emergency contact.
Name of English Speaking Emergency Contact*

First NameLast Name
This person can...*

Be contacted to help translate while Waldorf contacts my main emergency contactBe contacted instead of my main emergency contact.
English Speaking Contact Relationship to Student*
English Speaking Contact Phone Number *
ex. 1-800-292-1903
English Speaking Contact Email Address*

Student Handbook/Health & Safety Policies Information

Student Handbook // Campus Emergency & Safety Procedures // Camps Security Report
By submitting this form, you are acknowledging that you have received information regarding the Student Handbook, which includes information on Sexual Assault / Harassment, HIPPA Policy, alcohol, tobacco & other drug information, Student Complaint Policy, and Code of Conduct. You are also acknowledging that you have received the Campus Emergency & Safety Procedures and the Campus Security Report. All of this information is provided in the links above and on the Waldorf University website.
Check below indicating you understand the above mentioned information:*

I understand

Payment Agreement
Payment Plan Options*

Payment in Full - I intend to promptly pay off the balance that will not be covered by Financial Aid or loans in one payment in full.Payment Plan - I wish to set up multiple payment dates to pay off the balance that will not be covered by Financial Aid and Loans, and/or I have already completed my Payment Plan form. **Payment plans are due to the business office during the check-in process. Please come prepared.**
Home billing address*

Street Address

Street Address 2

CityState / Province

Postal / Zip Code
Home billing address - Country*
I will have a parent or guardian that will be helping to pay for my schooling.*

YesNo - I am paying everything on my own.

Parent or Guardian offering financial help
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Email*

Payment Agreement - Statement of Understanding Required
By checking the box below, I promise to pay Waldorf University for tuition, fees, room & board, and any other cost for each term I attend. I am also liable for any new or previously unpaid charges that I have voluntarily incurred and were charged to my tuition/miscellaneous account including but not limited to health insurance (if applicable), parking violations & other fines. A monthly 1% interest charge will be added to accounts without a payment plan. If you are unable to pay in full contact the Business Office immediately to make payment arrangements. I understand that any unpaid charges will remain my liability and if remitted to a collection agency there will be additional fees. The university will withhold transcripts and diplomas until all financial obligations have been paid. I hereby express consent to and further knowingly provide my cellular or other telephone number and any subsequent change in contact numbers or other means of communication including but not limited to electronic mail at the address provided by me to Waldorf University as a means of the university or any debt collection agency or debt collection attorney hired to contact me by the means of a prerecorded messaging system or by means of social networking sites to collect said obligations.

**All University Statements will be provided to you monthly via electronic means. You can submit a request for paper billing to the business office**
Check below indicating you agree to the above mentioned information:*

I agree

Authorization to pay Miscellaneous Charges

This form is used to authorize Business Affairs to use excess financial aid funds to pay miscellaneous charges on your student account.
Checking the boxes below shows that you understand that you will authorize Waldorf University to use any excess funds from your financial aid to cover miscellaneous charges owed. This will remain in full effect until Waldorf University has received written notification from you of its termination in such time to allow the University a reasonable opportunity to act on it.

I AUTHORIZE Waldorf University to apply excess funds from my financial aid directly to my tuition to cover miscellaneous charges currently owed.I UNDERSTAND that normally all excess money would be refunded directly to me and it is my choice to waive the refund process.I AUTHORIZE Waldorf University to apply excess funds from my current financial aid to my non-current account to cover prior charges (not to exceed $200)

Student Health Insurance
Waldorf University requires all full-time students (12+ credit hours) to carry primary health insurance, either through a family employee health plan, a private insurer or through the plan offered by the University; Wellfleet Insurance. It is up to each student to determine if their insurance plan is accepted at local medical providers to Forest City, Iowa and to decide if their insurance coverage has sufficient coverage for non-emergency medical providers. // The Wellfleet plan offered by Waldorf is accepted at all area medical providers surrounding Waldorf and many locations across the USA through the First Health Network. Please see the Wellfleet flyer for details on the benefits.

Options for purchasing the Wellfleet Insurance offered by Waldorf University:
- Option 1: Annual coverage Aug. 1, 2024– July 31, 2025
- Option 2: Spring only coverage Jan. 1, 2025-July 31, 2025
Information & cost of the coverage can be found on the Wellfleet website at https://www.studentinsurance.com/Client/969
Waldorf University NEVER pays for any provider visits or other medical charges. All medical bills are always the students’ responsibility to pay. Failure to pay the medical providers for charges not covered by insurance could result in you being sent to a collection agency and effect your credit rating.*

I have read and understood the above statement.
Would you like to provide your own health insurance policy or purchase health insurance through Wellfleet?*

I, of my own free will, request enrollment in Wellfleet for 2024-25 and I understand the premium for this option as above to be billed to my account.I, of my own free will, request to use my own primary health insurance policy. I understand that I must provide a copy of my insurance card to Waldorf University.

Signature

This is your electronic signature. By providing your full name below, you are agreeing that you have read all statements and questions listed in this form and answered truthfully and to the best of your ability.
Type your full-name*
Signature*

Clear
Date*

MonthDayYear
Type your full-name
Parent/Guardian Signature (Required if under 18)

Clear
Date

MonthDayYear
Should be Empty:

Pre-Arrival Check-in Form - Spring 2025

Housing

On Campus Address

Off-Campus Housing Address

Waldorf Laptop

Vehicle Registration

Vehicle Registration Information

Emergency Contact Information

English Speaking Emergency Contact

Student Handbook/Health & Safety Policies Information

Payment Agreement

Parent or Guardian offering financial help

Payment Agreement - Statement of Understanding Required

Authorization to pay Miscellaneous Charges

Student Health Insurance

Media Release Authorization

Signature