Residence Hall ApplicationResidence Hall Application • September 9th, 2013
Contract Type FiledSeptember 9th, 2013A $200 refundable deposit is required with this application (check or money order payable to Southern Union State Community College). This housing agreement is a legal and binding document for the full academic year (fall and spring semesters). Residents are financially responsible for all room charges. An assignment space must be claimed by the second day of move in or the space will be reassigned. STUDENT INFORMATION Student #: SUSCC E-mail Address: Date: Ethnic Group (Optional) Last Name: First Name: Middle Name: Birth Date: Gender:Male Female Street Address/P.O. Box: City: State: Zip Code: Home Phone: Cell Phone: Last Four digits Social Security # I plan to enter SUSCC: Calendar Year 20 Fall Spring Summer SUSCC Academic Scholarship Presidential Ambassador Technical SUSCC Athletic Scholarship Women’s Basketball Men’s Basketball Women’s Softball Men’s Baseball Women’s VolleyballCheerleading SUSCC Performing Arts Scholarship Dance Show Choir TheatreTechnical Crew ROOMMATE INFORMATIO