Off Campus Housing Application - Paul Smiths College printable pdf download

Off-Campus Housing Application

Paul Smith’s College • Housing Office • Routes 86 & 30, Paul Smiths, NY 12970 • 518-327-6128

This form is due for returning students:

Fall Semester: by July 1

Spring Semester: by December 1

Failure for returning students to submit form by date due will result in a $50 fine. No applications accepted or approved after semester begins, and

no room refunds made. Board refunds will be pro-rated.

***Do not sign a lease to live off campus until you receive written permission from the Housing Office via email***

PLEASE PRINT:

First Name: _________________________ M.I.______

Last Name: _______________________________

Date of Birth: _________________

Date of Entry__________________________

Full Time or Part Time (circle one)

Please list the semesters that you have lived on campus_____________________________________________

Academic Year for which you are applying________________________________________________________

Phone: __________________________________

THIS FORM WILL BE VALID FOR THE ACADEMIC YEAR YOU ARE APPLYING FOR.

*On-campus housing applications have a term of one year and no student may move off campus once a semester has

begun. Permission to live off campus is only granted for the upcoming semester, and EVERY off-campus student

must reapply prior to the start of each academic year*

***Do not sign a lease to live off campus until you receive

written permission from the Housing Office via email***

Please check the criteria to live off campus that applies to you:

1.________

I am 21 years of age or older

2.________

I am living at home with parents or guardians within 20-40 miles

3.________

I am living with a dependent child.

3.________

I am married or entered into a civil union.

4.________

I am a veteran with at least one year of active military service.

5.________

I have lived within a residence hall for at least 4 consecutive semesters

New off campus address will be:

________________________________________________________________________________________

________ I have reliable transportation back and forth to classes. (Form will not be approved without acknowledgement)

_______ I have not been placed on any form of college probation within the past academic year and will not be entering the new

academic year under a probationary status (Form will not be approved without acknowledgement)

Should you have any further question please contact the Housing Office at 518-327-6128 or at StudentAffairs@paulsmiths.edu

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Off Campus Housing Application - Paul Smiths College