All residence hall agreements are for the fall and spring semester. If you have any conditions, medical or otherwise, that are important for us to know, contact the Office of Residence Life at firstname.lastname@example.org or call (212) 678-8035 when you submit your application.
* indicates a required field.
Last Name: *
First Name: *
Gender: * Male Female
Date Of Birth: mm / dd / yy *
Cell Phone: *
Alternate Phone: *
Do you use electricity on Shabbat? * Yes No
Do you mind if your roommate uses electricity on Shabbat?* Yes No
Do you prefer a heksher kosher kitchen or an ingredient kosher kitchen? *Heksher kosher kitchen means all food brought into the kitchen (except ingredients like fresh fruit and vegetables) must have a recognized hekhsher (symbol of kosher supervision) on it, or have been prepared in a "hekhsher kosher kitchen". Ingredient kosher kitchen means food may be brought into the kitchen as long as its ingredients are kosher (all meat in "ingredient kosher kitchens" must have a hekhsher).Heksher Kosher Ingredient Kosher
Is there any student with whom you would like to be housed? Please note that all roommate requests must be mutual; all housing applicants must list each other in order for your request to be prioritized.
On a scale of 1–5, indicate your level of agreement for the following statements.