STUDENT HOUSING APPLICATION

For New & Returning Students

Congratulations to all newly accepted students and welcome to the Five Towns College community! New students as well as returning students who desire to live on campus are encouraged to submit the Student Housing Application early. Since there are a limited number of rooms, it is important that those who would like to live on campus secure their spot by following the Instructions below.

Completing this Application does not guarantee a room assignment for the semester but it is necessary for students to reserve a room and, thereby, have their names entered on the housing roster. So, please carefully read and complete the questions presented, and submit your responses. Returning students must be in good academic standing in order to reside on campus.

INSTRUCTIONS:

Please read this Student Housing Application and the Conditions of Residence Living by clicking here. Then, acknowledge your understanding and agreement by completing and signing the online Application and click submit. It is suggested that you retain a copy of the Conditions of Residence Living for your records.

I. STUDENT INFORMATION

Applicant Name

First(Required)

Last(Required)

Middle Initial

Preferred Name

For Returning Students, FTC Student ID#:

My permanent address is located within:(Required)

United States

Canada

Other country

Permanent Address(Required)

Street Address Address Line 2 City State ZIP Code

Permanent Address(Required)

Street Address Address Line 2 City Province Postal Code

Permanent Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address(Required)

Cell Phone(Required)

By providing a cell phone number, I consent to receive SMS/text messages from Five Towns College.

Date of Birth(Required)

Sex(Required)

Male

Female

Other

How do you identify?(Required)

What time of room do you request?(Required)

Please note- there is limited availability of single rooms and no guarantee that this can be assigned

Single

Double occupancy

Emergency Contact Person(Required)

Please enter the name, relationship, and number of a person who should be contacted in the case of an emergency. You can add more than one person by hitting the plus (+) button.

Name

Relationship

Telephone Number

I am applying for campus housing as a Five Towns College student. I understand that if I receive a housing assignment, and I decide not to attend Five Towns College that I must notify the College in writing prior to July 1 st for the Fall Semester and January 2nd for the Spring Semester to receive a full refund of my housing deposit.
I understand that I will be held responsible for the payment of the residence fees in accordance with terms and conditions set forth in the Five Towns College Catalog and Residence Life Handbook, which is incorporated herein by reference.
Room assignments are made without regard to race, religion, color, creed, national origin or veteran status. The Residence Life Office merely attempts to match roommates on the basis of similar living habits and interests.
The Meal Plan is mandatory for all students living on campus.
Five Towns College has a no-smoking policy in the Residence Halls and Campus Buildings. There are just a few designated smoking areas outside on campus.
Motor Vehicles are permitted on campus as long as they are registered in the Public Safety Office.
If approved, my Residence Hall license shall remain in full effect while I reside on campus but may be revoked for any violation of its terms and conditions.
I hereby assume all risk incident to my residence at Five Towns College and agree to indemnify and save harmless Five Towns College Real Property Trust, Five Towns College, its employees, agents, and assignees from and against all losses, claims, actions, suits, expenses, liabilities, damages, or legal fees on the account of any loss, or injury to persons or property incurred by or caused by the acts of the undersigned, except for gross negligence on the part of the College.
Additionally, I understand and agree that college officials may conduct a search of my room on occasion and pursuant to the Residence Life Handbook and this Student Housing Application if there is reason to believe that violations and/or unlawful events have taken place or, in any event, for health and safety inspections as stated therein.

Application Agreement(Required)

I hereby verify that my responses are truthful and that I have read and agree to abide by the terms and conditions of this entire application, including the Conditions of Residence Living .

Signature(Required)

Name(Required)

First Last

Date: 03/20/2023

Are you under 18 years of age?

Yes

Signature of Parent or Guardian(Required)

(required if student is under 18 years of age)

Name of Parent or Guardian(Required)

First Last

Date: 03/20/2023

II. Roommate Assignment Questions

What is your expected class status for next year?(Required)

Freshman

Sophomore

Junior

Senior

Are you a transfer student?(Required)

Yes

Do you have a roommate preference?(Required)

Yes

Name of roommate

First Last

Medical/Physical or Emotional Conditions

Indicate any medical/physical or emotional conditions that should be considered when making a room/roommate assignment, including whether you have any ALLERGIES and what they are, ie. seasonal, food, and/or any other. Please provide medical documentation, if none indicate “None”.