Questions? Call 660-864-4986.

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A private university housing complex adjacent to the University of Central Missouri campus.

HOUSING RESERVATION

Applicant Name

Date of Birth

Phone

Email

Full Address

Passport #

Passport Issued By

Drivers License #

Drivers License # Issued By

Attach a copy of passport or picture ID. Browse to find a file:

Date of Admission to the Unversity of Central Missouri

Major

Hours Completed

Health Issues and Limitations

Last Landlord

Landlord Phone

Parents

Parents Full Address

Emergency Contact

Emergency Contact Phone

Emergency Contact Country

I would like to request occupancy beginning

and ending

 

I would like a private suite.

 I would like to share a suite with

 

I agree to share common areas with other residents and respect their right to use the facilities.

 

I understand this agreement may be terminated immediately due to false statements, breach of conditions of occupancy or non-payment of fees upon written notice by House Manager.

After this reservation has been received, the House Manager will contact you
  by email, phone, or Skype for an interview.
• Upon receipt of "Notice of Acceptance", mail or wire escrow deposit to
  guarantee your reservation.
Upon arrival, you must sign the Housing Agreement and pay the housing fee
  to obtain your key and occupy your suite.

Confirmation Code