Request Housing Information

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	Welcome Week 2008

REQUEST FOR HOUSING INFORMATION

If you are an international student, please e-mail University Housing Services to request housing information.

YES, I am interested in receiving contracting information for the RESIDENCE HALLS!:	Yes
YES, I am interested in receiving contracting information for the RESIDENTIAL SUITES! (*Not available to first time freshman):	Yes
YES, I am interested in receiving contracting information for the CENTER FOR REGENERATIVE STUDIES - CRS. (*Not available to first time freshman):	Yes
I am applying for: *
Bronco ID Number: *
Email Address: *
Last Name: *
First Name: *
MI:
Address: *
Address Line 2:
City: *
State: *
Zip Code: *
Country:
Telephone (xxx-xxx-xxxx): *
Gender: *	Female Male
Date of Birth (MM/DD/YYYY): *
Major:
Entering Class Level: *
Are you an accepted or provisionally accepted student at Cal Poly Pomona?: *	Yes No
Special Code:
Email address of parent/guardian (to receive copies of messages sent to students):

* By submitting this form, I will be placed on the e-mail list to receive notification of when the License Agreement will be available online.

* You must complete the Housing License Agreement online and mail a signed copy with your first payment in order to be considered for housing.

* The License Agreement for the Summer Quarter 2008 and Fall Quarter 2008 will be available starting April 9th, 2008 at 4:00PM.

Be sure to add housing@csupomona.edu to your email contact lists (or to your trusted addresses) to ensure that you receive messages from us.

The information that you provide is for confidential use by University Housing Services. University Policy prohibits discrimination on the basis of race, color, national origin, religion, sex, age, or sexual orientation.

Updated On: May 8, 2008

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