Name ____________________________________________________________________________________
Last First Middle
Home Address_____________________________________________________________________________
Street or P.O. Box
____________________________________________________________________________
City State Zip Code
Social Security Number_______________________________ Female_____ Male_______
Have You Attended GSU Before? Yes___ No___ If yes, when_____________________________________
Are you transferring from another college/university?
Yes____ No____
If Yes, Where ______________________________________________________________
This request for what term: Fall 19___ Spring 19_____ Summer 19_____
Classification Upon Entrance: Freshman___Sophomore___Junior___Senior___
I wish to donate my $50 damage fee deposit (or any residual amount) to the Grambling State University Housing Department upon my graduation or withdrawal from the university: Yes___ No___
I have read the contract below and agree to comply with it as stated.
STUDENT'S SIGNATURE__________________________________________________ DATE SIGNED___________________
On November 4, 1969, the Louisiana State Board of Education adopted a resolution, affecting the housing policy at Grambling State University and all other colleges and universities under its jurisdiction. In compliance with the State Board's resolution, Grambling State University has adopted the following on-campus residency requirements. ALL UNMARRIED, FULL-TIME, UNDERGRADUATE STUDENTS, REGARDLESS OF AGE AND OF WHETHER OR NOT EMANCIPATED, EXCEPT THOSE LIVING WITH PARENTS, ARE REQUIRED TO LIVE IN ON-CAMPUS RESIDENCE HALLS AS LONG AS SPACE IS AVAILABLE.
Applications for exemptions from the on-campus residence hall requirement must be in writing to the DIRECTOR OF HOUSING no later than two (2) weeks prior to the opening of the semester. The student will be notified in writing of the decision rendered by a committee. (Forms are available in the OFFICE OF THE HOUSING DIRECTOR).
Students planning to live on-campus must complete this STUDENT RESIDENCE REQUEST FORM and return it with a $50.00 DAMAGE FEE to the HOUSING OFFICE, P.O. BOX 864, GRAMBLING STATE UNIVERSITY, GRAMBLING, LOUISIANA. CERTIFIED CHECKS, MONEY ORDERS, CASHIER'S CHECKS AND TRAVELER'S CHECKS for the $50.00 should be made payable to GRAMBLING STATE UNIVERSITY. DO NOT SEND CASH NOR PERSONAL CHECKS. The deposit will be held until the student is no longer enrolled at the university or until the student requests and receives approval of exemption from on-campus living. It will be refundable if the reservation is cancelled 30 days before the opening of the semester for which campus housing is requested.
TERMS UNDER WHICH ROOMS IN THE RESIDENCE HALLS ARE ASSIGNED
Student's contract for room assignment is on a semester basis. Any student not withdrawing from school, but moving off campus by choice and with permission of proper authorities, will pay residence hall cost for the remainder of the semester after the fourteenth (14th) class day.
Students living in residence halls are required to purchase appropriate meal tickets for eating in the University Dining Hall.
Students who specify mutual roommate and residence hall preferences are placed as requested, if possible. The assignment is made at the discretion of the Housing Director.
Certain regulations have been established for the maintenance of good living conditions in the residence halls. Students agree to follow published regulations in accepting their room assignments.
Permission to exchange, transfer, or vacate rooms must have the approval of the Housing Director prior to any such changes.
Upon accepting an assignment, a student agrees to permit authorized University representatives to have access to the room when circumstances warrant such action.
The Damage Fee serves as a deposit once the room is occupied, and is valid for the duration of a student's stay in residence halls. If a student fails to check out properly, the deposit is forfeited. Any assessed damages or losses will be deducted from the deposit and any balance will be remitted to the student.
Room assignments and/or keys are non-transferrable.
The student contracts to occupy rooms only during the time the academic program is operative as stated in the catalog.
Students wishing to cancel their Damage Fee deposit must do so in writing thirty (30) days before the beginning of the semester for which housing is required. Unless such cancellation is made, the $50.00 damage fee deposit will be forfeited.
Student may guarantee a room assignment by paying an advance room reservation fee of $200 for each semester and $100 for the summer term at least thirty (30) calendar days prior to the opening of the residence halls. Room assignments will be guaranteed on space available basis.
