Residential Hall Agreement and Contract

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Name(Required)

First Middle Last

Permanent Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Student ID Number(Required)

Gender(Required)

Date of Birth(Required)

Classification

Academic Major

Parent or Guardian Information

Parent or Guardian Name(Required)

First Last

Relationship of Parent or Guardian(Required)

Parent or Guardian Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent or Guardian Phone(Required)

Parent or Guardian Work Phone

Preferred Roommate

Name(Required)

First Middle Last

PLEASE INDICATE ANY CHRONIC AILMENTS THAT SHOULD BE CONSIDERED WHEN MAKING YOUR ROOM ASSIGNMENT

Terms and Conditions of Residence Hall Agreement

The initials and signature of a student on this application and contract signifies that he/she agrees to and accepts the following terms and conditions. Each Residential Hall Agreement is personal and may neither be transferred or reassigned by the student(s). Please initial each statement after reading

Rental Period: The rental period is for the entire academic year beginning on the first day of move-in and ending on the last day of move-out after the spring semester. Agreements made any time after the actual opening of the Fall Semester are effective until the close of the academic year. Initial here:

Room Fee: One Hundred dollars ($100.00). The payment of a room fee guarantees eligibility for a room assignment. The fee is not applied as a payment against the total cost of the applicant’s room rent. Room fees are non-refundable, except when the college is unable to furnish a room. Room fees are due annually by June 1st. Initial here:

All room assignments are on a “first-come, first-served” basis. This means, in the order that we received your application and room fee, is how we will make your assignment. Please note ALL freshmen will stay in housing designated for First Year Living and Learning, unless an overflow occurs. Transfers and re-admits will be housed first-come, first-served. Initial here:

Rental Charge Payments: Semester rental charges are included in student’s billing by the Business Office. Initial here:

Refund: A student who officially withdraws from the College during the first five (5) weeks of a semester is entitled to a refund of fees for that semester if the students finances allows. The refund is based on the following scale

Withdrawal Period
During 1st or 2nd Week……... 80% During 3rd Week……... 60% During 4th Week……... 40% During 5th Week……... 20%

General Provisions: The College reserves the right to (a) change any room assignments; (b) enter rooms for routine inspections, repairs or housekeeping at any time deemed necessary for institutional reasons or purposes; (c) enter rooms to inspect for rule violations at any time deemed necessary with just cause; (d) control rooms in case of an epidemic; and (e) terminate the Residential Hall Agreement for reasons deemed sufficient by College Officials such as President, Vice President for Student Affairs, and the Director of Residential Life. Reasons are as follows: obsessive residence hall violations (3 or more), non-compliance and etc. Initial here:(Required)

Room Charges begin on the first official opening date of the residence hall and ends when the student returns the key to their Residential Life Coordinator or at the end of each semester. Initial here:(Required)

In keeping with College policy, room assignments are made without discrimination to race, religion, sexual orientation, color or national origin. The College reserves the right to make guidelines as it deems necessary for the protection of all properties and for the safety, health, comfort and convenience of the student living in the residential communities. Initial here:(Required)

Please list (if any) chronic ailments:

PLEASE NOTE: BENEDICT COLLEGE IS NOT RESPONSIBLE FOR THE LOSS, THEFT, OR DAMAGE OF PERSONAL PROPERTY BELONGING TO RESIDENTS. EACH STUDENT MUST PURCHASE THEFT INSURANCE TO COVER ALL PERSONAL ITEMS. Initial here:(Required)

ANY STUDENT IN VIOLATION OF THE ABOVE CONDITIONS OF THE CONTRACT, VIOLATING COLLEGE AND RESIDENTIAL POLICIES, NOT ADHERING TO ADMINISTRATOR OR STAFF DIRECTIVES OR ORDERS, WILL BE REMOVED FROM THE RESIDENCE HALL WITHOUT FINANCIAL ADJUSTMENTS OR REFUND. Initial here:(Required)

I hereby apply and agree to the terms and conditions in the Residential Agreement for the full academic year, even if the start date of this agreement is after the start of the semester. I have read and understand that this is a contract and that it is enforceable for the entire duration of my residential experience. Initial here:(Required)

Residential Hall Agreement and Contract

Parent or Guardian Information

Preferred Roommate

Terms and Conditions of Residence Hall Agreement

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