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Application1
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Application1
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Housing Application (Page 1/3)
Date
*
Date
Last Name
*
First Name
*
Middle Name
Student ID #
Date Accepted to MBTS
*
Date
Academic Level
*
FUSION
UNDERGRAD
GRADUATE
DOCTORAL, Ph.D
Doctoral/PhD
– Only considered, upon availability, by approval of a submitted
exception request
Gender
*
Male
Female
Birth Date
*
Date
Email Address
*
Permanent Address
*
City
*
State
*
Zip Code
*
64118
Cell Phone #
*
(ten digit number, no dashes)
Other Phone #
(ten digit number, no dashes)
Anticipated Graduation
Date
Resident Status
*
Incoming Resident
Current Resident accepted for new MBTS degree requesting to remain in current apartment (no fees required).
Current Resident Requesting a Change of Unit
If requesting a change of unit:
*
Requires a one time, non-refundable change fee of $250.00 for families or $100.00 for non-families (single students).
I understand this request will expire after 3 months
I will provide my reason for change request in the notes on page three
I will submit an additional housing deposit - $250.00 family/$100.00 non-family. The vacated apartment deposit covers any damages, as determined by the vacate inspection. Any unused deposit funds will be returned to my student account.
Requested Move in Date
*
Date
Marital Status
*
Single
Married
Engaged
Wedding Date
Date
Spouse Name
*
Spouse Birth Date
*
Date
Spouse Cell Phone #
*
(ten digit number, no dashes)
Spouse Email
*
