A branch of Webber International University
Did you know...
With St. Andrews' study abroad programs, you can live in a 14th Century castle in the Italian Alps, attend the University of Cuenca in Ecuador, experience Chinese language and culture at Capital Normal University in Beijing, China, as well as many other opportunities.

New Student Residency Contract


Prior to completing this form, make sure to read
Housing/Food Services Statement of Terms and Conditions of Occupancy.

Personal Information

Semesters Attending
Academic Year 2014-2015
Fall Spring
Incoming Class Rank: Freshman Sophomore Junior Senior
First Name:
MI Last
E-mail: 
Gender:
Male:   Female:    
Social Security #:
 
Date of Birth:
Home Phone:
 
Student Cell Phone:
 
Home Address:
     
City:
State Zip
Country:
 
Parent/Guardian1:
Work:
Cell:

Email:
 

Parent/Guardian2:
Work:
Cell:

Email:
 

In Case of Emergency Contact  
Name:
   Phone:
Relationship to you:
Cell Phone:
   

Please Note:

*New students who are 26 years or older require permission from the Dean of Students to live on campus. Permission is granted only in special circumstances.

*All incoming new students are also required to complete the New Student Housing Survey unless they make a roommate assignment request at the bottom of this form.

 

Residential Student

Special Housing Needs: Students with medical or disability-related housing needs must complete the Disability Assistance eligibility process, and document their specific needs with the Director of Disability Services (910) 277-5667.
I will need special housing arrangements.
I will not need special housing arrangements.
   
Telephone Request: Please designate whether you would like St. Andrews to provide a Cisco VOIP landline phone in your residence hall room. If you decide to have a landline phone, you must agree to set up the voicemail. We will only provide one phone per room.
I want St. Andrews to provide a Cisco VOIP landline phone in my residence hall room and agree to set up the voicemail.
I do not want a CISCO VOIP landline phone in my residence hall room. I will use my cell phone number as my phone contact.
I want to receive campus emergency text notifications on my cell phone.
   
Roommate Assignment Request: If you already have identified a person with whom you wish to live, please complete the following:
Name of requested roommate:
Important Note: Both students must request each other and submit their contracts before the assignment can be finalized.
   

Agreement

Residential Student Agreement: I request that the university proceed to assign room and board accommodations in keeping with the terms of this contract.

 

I acknowledge that by submitting this form, I am providing an electronic signature verifying that the information is correct as submitted and an accurate reflection of my consent as indicated above. I further verify that I have reviewed and understand the Housing/Food Services Statement of Terms and Conditions of Occupancy.


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St. Andrews University
A branch of Webber International University
1700 Dogwood Mile
Laurinburg, NC 28352
(910) 277-5555 • (800) 763-0198 • (fax) 910-277-5020
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