This box for office use only.
Student ID:
Lourdes Commons - Housing Application
2015-2016 ACADEMIC YEAR
FALL 2015 CLASS STANDING:
1st YEAR
SO
JR
SR
GRAD
Name: _______________________________________________________________ Gender:
TRANSFER
Female  Male
Home Address: ________________________________________________________ Student Cell:__________________________
City/State/Zip: ________________________________________________________ Home Phone:_________________________
Student Email: ________________________________________________________ Birthdate: ____________________________ *Mother/Father/Guardian Name:___________________________________________ Are you a student athlete? Y
N
*Mother/Father/Guardian Phone: __________________________________________ If so, what sport?_______________________
*For emergency notification only.
Have you been awarded an athletic scholarship?
Have you applied for Honors/Scholars programs? Y N
Y N
*Price Per Semester Per Student/Current Year Rates
Housing
 1 bedroom 1 student ......................... $7,200
 1 bedroom 2 students ........................ $4,900
 2 bedroom 2 students in master ......... $4,900
 2 bedroom 1 student in small room ... $6,000
*Graduate & Non-traditional Student 12 month leases
 1 bedroom single .................................. $570
 1 bedroom married .............................. $620
 Furniture rental....................................... $50
*Prices may change for 2015/16 school year.
No single 1 bedroom units will be assigned to incoming first year students.
*Meal Plan Rate Per Semester

19 meal with $100 spending.............. $2,100
 15 meal with $50 spending ................ $2,000
 10 meal with $50 spending ................ $1,800
All undergraduate traditional students must purchase a meal plan.
All first year students will automatically be assigned the 19 meal plan.
The Residence Halls will be closed from the end of the Fall term
until the day before classes start for the Spring term. The halls
will also be closed during Thanksgiving and Spring Breaks. All
students are expected to leave during the times the halls are closed.
If you would like to request a specific roommate, please print that person’s complete name in this box.
If you have a documented disability and require special housing accommodations, please contact the Accessibility Services
Office by e-mail at oas@lourdes.edu or call 419-824-3523.
It is the policy of Lourdes University that all students who have not reached the age of 18 by the day they move into a
Lourdes residence facility have a parent or guardian sign their housing application. By signing the housing application, the
parent or guardian is acknowledging that they can be held liable for the behavior of their underage dependent until the student
reaches 18 years of age. This includes damage to the residential facilities as well as other school property.
Lourdes has a priority deadline of May 1 for the Fall semester. Late applications may be considered in the order in which they
were received if beds are still available. Please submit this completed and signed form to:
Lourdes University
Residence Life
6832 Convent Blvd
Sylvania, OH 43560
PLEASE READ CAREFULLY:
This form does not guarantee that all of your preferences/requests will be granted. This form is for the Residence Life Staff to best match you
up with someone who shares common interests, values or a similar schedule. Lourdes reserves the right to make any and all final housing and
roommate assignments during the year for the good of the resident, the residential community, or any other reason deemed appropriate by
Lourdes. It is in your best interest to answer these questions as honestly as possible.
Circle one response for each question and then indicate roommate preference.
Same
I prefer that my roommate is:
Opposite
Neutral
1. I am a: Non-smoker
Smoker
An occasional smoker
Smoking is not permitted in any campus building including student housing.
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2. I go to bed at: 10 - 11p.m.
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alone in my room 
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12 - 1 a.m.
3. I am more active in: The morning
2 a.m. or later
The evening
4. I would describe myself as: very quiet
fairly quiet
5. I would describe myself as: very neat
usually neat
6. For studying, do you prefer: quiet
doesn’t matter
social
not concerned about neatness
moderately quiet
7. I believe that I will study each day: 1 hour or less
8. I am most comfortable: with large groups
very social
moderately noisy
2-3 hours
4 or more hours
with a few close friends
9. If you are over the age of 21, do you consume alcohol? Yes
No
10. What types of TV/Movies do you enjoy? Comedy
other:_________________ (circle all that apply)
Horror
Drama
11.What types of music do you enjoy? Alternative Classic Rock
Hard Rock/Metal Pop/Top 40 (circle all that apply)
noisy
Science Fiction
Country
Jazz/R & B Cartoons
Crime/Mystery
Classical
Dance/Hip Hop/Rap
12.What is your intended major for the 2015-16 school year?_______________________________________
I understand that acceptance of this application does not constitute a guarantee of assignment to a residential apartment nor
admission to the University. Also, I have read and understand the terms of this application as stated herein.
By signing below, I agree to abide by the policies in the Lourdes University Student and Residential Handbooks. The Lourdes
University Student and Residential Handbooks can be found on the Lourdes University web site.
Your information will remain confidential, to the extent possible, with the exception of the student’s name, address, e-mail.
An address and telephone number will be disclosed to the assigned roommate unless the student requests otherwise.
Student’s Signature:________________________________________________________Date:_____________
Parent or Guardian’s Signature:_______________________________________________Date:_____________
(Parent/Guardian’s signature is needed if student will not reach 18 years of age by the date they move into a Lourdes University
residential facility)