Freshman Housing Application

To submit a housing application, please complete the form below. All REQUIRED fields must be filled out in order for your housing application to be accepted. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.

• Students must be enrolled in a minimum of 15 semester hours in order to receive a room assignment.
• Roommate and dormitory assignments will be made according to your request on a first-come first-served basis.
• If a roommate preference is requested, the information regarding dormitory preference must match exactly meaning that both roommates must list the same dormitory preferences in the same order.
• A Minimum GPA of 1.75 for two semesters is required for dormitory residency.
• Out-of-state students who are not attending Holmes Community College on Athletics scholarship will not be housed on campus.
• Dormitories are closed on weekends except to out-of-state athletes on scholarship.
• Please do not submit a housing application if you do not fit into this category of future student, otherwise your application will not be accepted.
  

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*First Name

*Last Name

*Social Security Number

*Home Address

*City

State

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*Zip Code

*Phone

*Email Address

I am applying for

Spring 2019Fall 2019

Dormitory Preference

Womens Choctaw HallWomens Grenada HallWomens Yazoo HallMens Attala HallMens Cook HallMens MotelMens Webster Hall

Dorm/Floor/Room Number Preference:

Roommate Preference

Scholarships Received

Birth Gender

FemaleMale

Student Permission: By choosing ACCEPT, I confirm that all information provided is true and accurate.

Please Select CHOOSE AN OPTION ACCEPT DECLINE

*Initials

*Date of Birth:

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