HOUSING / ONLINE APPLICATION


NOTE: This application is to be completed by all students who desire residence life while attending Talladega College. Students who reside on campus are required to pay a non-refundable room fee of $200. A money order or cashier’s check made payable to Talladega College Office of Residential Life must be mailed or paid by August 1, 2016. Your application will not be processed until the non-refundable housing fee has been received.

Terms of Application

Your Name (required)

Gender (required)

Date of Birth (required)

Street Address

City

State

Zip:

County

Country

Phone

Your Email (required)

Marital Status:
SingleMarried

Roommate Preference: We do not guarantee roommate preferences or compatibilities.

Name of Requested Roommate - Choice 1

Name of Requested Roommate - Choice 2

NOTE: When a specific roommate is requested, the request must be mutual, and priority is given to the request on the receipt of deposits for each room resident.

I,,give the Office of Residential Life at Talladega College permission to release the following information, name and telephone number to my perspective roommate. I understand that Residential Life assumes no liability for honoring my request. I further understand that acceptance of this application does not constitute or guarantee a residence hall room or admission to Talladega College.

Parent(s) Signature (Required for students under the age of 18)

Date:

Your Classification:

Do you require health accommodations?YESNO

Who should we contact in case of an emergency?

Relationship to you?

Home Telephone Number

Address

City

State

Zip Code

Insurance

We highly recommend students to purchase fire and theft insurance for the term of this application. The Office of Residential Life will provide information regarding fire and theft insurance per the student?s request.

RESIDENTS ARE ENCOURAGED TO CARRY SOME FORM OF PERSONAL PROPERTY INSURANCE. IT IS UNDERSTOOD THAT the college IS NOT RESPONSIBLE OR IN ANY WAY LIABLE FOR THE LOSS, THEFT, OR DAMAGE OF PERSONAL PROPERTY BELONGING TO RESIDENTS.

Liability

By signing this application, you will be subject to the Office of Residential Life policies, procedures, rules and regulations; in addition, to those governing the college. Failure to adhere to the rules or regulations may result in disciplinary sanction, including but not limited to; residence hall eviction, college suspension or expulsion, or imposition of monetary fines. Please refer to the student handbook/academic planner.

Talladega College is committed to the principle of the equal educational opportunity, equal employment opportunity, and affirmative action. Talladega College does not discriminate on the basis of race, color, sex, disabilities, age, religion, national origin, or veteran status pursuant to the requirements of the Title IX of the Educational Amendments of the 1972, the Rehabilitation Act of 1973, or any other applicable statutes.

Signature of Applicant

Date

NOTE: The The $200.00 Housing Fee is non-refundable.

Failure to complete the entire Housing Application will delay processing.

I agree to abide by the regulations of Talladega College pertaining to dormitory life and student code in general.

Enter Name: