Please complete the application and then print the form and send it to
Office of Residence Life 230 Egbert Hall 814-393-2352
Special Note: Students selecting to move into the Residence Hall during the Fall semester are contracting to live in the halls during both the Fall and Spring semesters, unless they do not enroll for spring classes.
Semester you would like to move into the Residence Halls
Fall Semester Spring Semester Year
Full Name:
Birth Date: Student's Clarion ID Number: Student ID Conversion Information
Male/Female Select Male Female
Parent or guardian's name:
Address:
City: State: Zip:
Phone: Hall Preference: Select Ballentine Becht Givan Nair Wilkinson Select up to three choices
Roommate's Status: Select Current Student Incoming Student Readmitted Student
Smoking Preference: Select Non-Smoking Smoking No Preference Starting Fall 2005, all of our Residence Halls will be SMOKE FREE!
Visitation Preference: Select Regular Extended Early Bedtime: Select Yes No
Early Wake-Up: Select Yes No Study Preference: Select Quiet With Music Music Sometimes
Roommate Preference:
(Student's Name) Roommate preference must be mutual.
Which Preference is most important:
Major:
Special Factors:
