APPLICATION FOR HOUSING AND BOARD

 

 

Name  
ASU ID   
Home Address   
City|State|Zip   
Telephone Number   
Email   
Current Hall   
Room#   
Room phone#   
ASU BOX#   
Classification  
   
Gender  
   
Semesters in Hall   
Roommate Preference 
Roommate   ASU ID  
 Summer school information (please select which sessions you will be staying)
   
 
Meal Plan Options  
   

 By clicking submit I certify that I have read all terms and conditions of the Residence Hall Lease and agree to the conditions stated herein.  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.  As long as I am enrolled at Alcorn State University, I must fulfill the obligations of this contract as stated in the Terms and Conditions.  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