Application for Residence Hall

INSTRUCTIONS

Send this application to:
Director of Summer Session
304 Wigwam Building
Hampton University
Hampton, Virginia 23668

Date: Student ID #:
Miss Mrs. Mr.
Last Name: First Name:
Middle Name: Telephone #:
Address(Mailing address prior to opening of Summer Session):
Age: Field of study:
Physical Disability Yes:No: Describe if yes:
In case of emergency, who should be contacted?
Address:
Relationship: Telephone #:
Have you ever been a resident student at Hampton University? Yes:No:
If so, when?
Do you have a choice of roommate? Yes:No:
If so, whom?
Do you smoke? Yes: No:
Check Current Status: Indicate Session(s) you plan to attend:
Graduate Student Session I (May 30 - June 27, 2014)
(4-wks session)
Undergraduate Student Session 2 (June 16 - July 25, 2014)
(6-wks session)
Pre-College/Summer Bridge Session 3 (June 30 - July 25, 2014)
(2nd 4-wks session)
Special (Non-HU Student) Pre-College / Summer Bridge (June 20 - July 25, 2014)
(5-wks session)