Personal Information

First Name *

Last Name *

Email *

Date of Birth *

Application Number

Self-Identify *
—Please choose an option—MaleFemaleOther

Contact Phone Number *

Education

Home University/ College/ Institution

Current Year of Study
—Please choose an option—1st YearUpper YearGrad SchoolNot Applicable

School to Attend for Duration of stay *

Study Program *

Will you be Domestic/ International- Exchange student?
—Please choose an option—Domestic UndergradDomestic GradInternational UndergradInternational GradNot Applicable

Housing

I'm applying to: *
—Please choose an option—Meal PlanNon-Meal PlanEither

Indicate your requested time of lease: *
—Please choose an option—September - AprilSeptember - DecemberJanuary - AprilPartial SummerFull Summer

If you have an intent of sharing a house or a room with someone, Please specify name? (They must also submit an application)

Room/ House Preference

Please select a desired Room size
—Please choose an option—XL/ JumboLargeMediumRegularSmallExtra SmallAny

Which type of house you prefer
—Please choose an option—Party houseQuiet houseDoesn't Matter

Coop Duties and Responsibility

Did you know that you must complete three Ops Hours (required volunteer hours) per semester to maintain the general operations of the co-operative? By selecting Yes, you agree to this commitment*
YesNo

To maintain the meal plan did you know meal plan members are responsible for three hours of kitchen duties a week? By selecting Yes, you agree to this commitment*
YesNo

Reference

We accept references from Existing or previous Coop members, Landlords, employers etc.

Reference Name

Reference Email *

Relationship to Reference *

Reference Number

If you were referred to KSHC by a Co-op member, please provide their name