Private Room Request Form

This form is only for current or returning students.

"*" indicates required fields

Student Name*
Birth Date*

A private room is available only on the basis that such rooms exist after all students have been housed. In order to consider the request, a current housing contract must be signed. Freshmen are not traditionally granted private rooms. Any student that requests a private room for fall semester will automatically be charged a private room fee for the following spring semester.

When available, private rooms will cost $9,270 per year/ $4,635 per semester (a regular double room is $4,635 per year/ $2,318 per semester) (a triple room is $3,708 per year/ $1,854 per semester) The student billing will show a regular room charge and then the additional Private Room Fee, that adjusts the basic room charge up to the Private Room Cost.

I acknowledge that I will be charged $9,270 per year/$4,635 per semester for a private room.

This will show as:

Room RatePrivate Room Fee
For a Regular Double Room
$4,635 per yr/$2,318 per semPLUS$4,635 per yr/$2,318 per sem
For a Triple Room
$3,708 per yr/$1,854 per semPLUS$5,562 per yr/ $2,781 per sem

I acknowledge that a private room is based on availability and that this request does not guarantee a private room. If I am placed with a roommate, then my account will be charged appropriately.
I agree and acknowledge that this document can be executed electronically and it is binding in every way as if signed by my hand.
Student Electronic Signature: Date*