Commuter Housing

Title:

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Work Phone (if applicable):

Email:

Birthdate (mm/dd/yyyy):

Residency Requirements

Crown College is a residential college. All single students not living with immediate family are required to live in college housing unless prior permission is given. At the discretion of the director of housing and student programs, it may be possible for a single student to live off-campus with variables of the following criteria. Please choose all that apply to you:

Student's 22nd birthday falls before the first class day of the semester they are applying.

Health needs demand special facilities that the College cannot supply.

Living with one or both parents.

Carrying six or less credit hours.

Special work situation exists which requires the student to live where they work, i.e., live-in rehabilitation or disabled/special-care facilities or service-oriented ministries.

I am married.

Any housing contract or lease agreement made while not enrolled at Crown College does not exempt an individual from the on-campus housing requirements.

By choosing Yes, I understand that I have created an electronic signature as legally binding as my handwritten signature.

Signature:

Signature Date (mm/dd/yyyy):

Please provide the address of your prospetive home, phone number and housing owner:

Owner

Owner Street Address:

Owner City:

Owner State:

Owner Zip:

Phone: