APPLICATION FOR HOUSING AND BOARD

 

Enter your responses below and click submit.  If you have questions, please call 601 877-6478.

Name   
   
Student ID#   
Telephone:   
Home Address:   
City:   
State:   
Zip:   
Email:   
Gender:  
               
Classification:     
               
Residence Hall Preference:  
               
 
 All university residence halls are tobacco free.
Roommate Preference:  
Name:  Student ID# 
 
 I request a PRIVATE room, and I agree to pay the extra charge if I am granted one. 
I understand that space is limited and students who have lived in campus housing for more conseutives semesters will be given priority consideration.
 
Meal Plan Options:  
         

This contract is binding for an academic year.  By clicking submit I certify that I have read and agree to all terms and conditions of the Residence Hall Lease
and agree to the conditions stated therein.  I further acknowledge that the Residence Life Handbook is part of the lease.  I further certify that all of
the representations made on my Residence Hall lease and my application form are true and correct.  Once accepted by the Department of Residence
Life, this lease is binding until otherwise agreed upon in writing.

Please mail your $125 NON REFUNDABLE APPLICATION FEE to:

Residence Life
1000 ASU DRIVE #60
Alcorn State, MS  39096-7500 


 
   

 

 

 

 

 
 
1000 ASU DRIVE   |   ALCORN STATE MISSISSIPPI 39096-7500   |   PHONE: 601.877.6100