Staythrough 2015 Application Deadline April 1, 2015 FOR OFFICE USE ONLY Received on: A minimum 15 night stay/charge will apply Last or family name Given or first name My UBC student number is: Assignment Preferred first name called if different from above Data entered Present room assignment Priority Assignment Home telephone Alternative telephone Please attach supporting documentation and indicate if you: Have a disability. Identify the nature of your disability Email (Residence offer or related correspondence will be sent here.) and the special accommodation required. Please INFORMATION RELEASE I request information release as detailed on the Student Housing and Hospitality Services website www.housing.ubc.ca/apply-info/application-forms/206. Yes No attach/forward a medical certificate (doctor's letter, etc.) to confirm. Regardless of your disability, you must be living independently. I am: Female Male My birthdate is: Day / Month / Year Student Status (Documents required with application) Summer student Practicum, from Late finish Day / Month / Year Grad student to Other Day / Month / Year • Students staying less than 30 days will be assigned rooms in Similkameen residence and are required to move to their new room on April 30. • Summer students staying more than 30 days will be assigned residence in Lower Cascades and are required to move to their new room on May 4. • All students who will be moving to a residence managed by Student Housing and Hospitality Services in September 2015 are required to relocate between August 22-24. Dates will be confirmed early August. • Students not moving to a residence managed by Student Housing and Hospitality Services in September 2015 are required to vacate no later than August 22, 2015. A minimum 15 night stay/charge will apply I will require accommodation from April 30, 2015 until: End– Day / Month / Year Roommate Preference If you want to live with specific roommates, you must staple your applications together, or if submitting by email, you must include all application forms as attachments in the same email message. We will use the following information to assign you with a roommate(s) who report similar lifestyle choices, but this is dependent on the space available and we cannot guarantee this will occur. Alcohol Use I don’t drink alcohol and prefer to live with non-drinkers. Select the one option from each of these categories that best describes you and your habits: Sleep Habits I am an Early Bird, I usually get up early in the morning I am a Night Owl, I usually go to bed late at night Living Space I keep my living space: Very tidy Messy from time to time Tidy Tidy is not very important to me In submitting this application I certify that I have read and agree to the application, assignment and refund policies as outlined on our website at www.housing.ubc.ca/residence-contracts-okan, and declare that the information reported on this form is true, correct and complete. I understand that if I am assigned accommodation based on incorrect information, or if my circumstances change, the contract may be terminated by the University and the accommodation is to be vacated immediately. I understand that application does not guarantee assignment. Return completed application to: Via mail: UBC Okanagan Student Housing & Hospitality Services 1290 International Mews Kelowna, BC Canada V1V 1V8 Via fax: 250-807-9157 Signature Date