First Name *
Last Name *
Email *
Date of Birth *
Gender * MaleFemale
Contact Number *
Current Year * ---1stUpper YearGrad School
School to Attend *
Program *
Are you an exchange student * NoYes
Did you know that you must complete three Ops Hours (required volunteer hours) per semester to maintain the general operations of the co-operative? * YesNo
To maintain the meal plan did you know meal plan members are responsible for three hours of kitchen duties a week? * YesNo
I'm applying to: * ---Meal PlanNon-Meal PlanEither
Indicate your requested time of lease: * ---September - AprilSeptember - DecemberJanuary - AprilSummer
Are you applying with the intent of sharing a house or a room with someone specific? * NoYes
If yes, what is their name? (They must also submit an application)
We accept references from Landlords, Dons or residence advisors, employers etc.
Please indicate your relation to this reference:
Reference Name
Reference Email
Relationship to Reference
Reference Number
If you were referred to KSHC by a Co-op member, please provide their name
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