OFFICE OF REISDENCE LIFE Name: Student ID #

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OFFICE OF REISDENCE LIFE

CONTRACT ACCEPTANCE FORM

2013-2014

PLEASE PRINT

Name:

_______________________________________________________

Student ID #

___________________________________

Gender:

______________________________

Date of Birth:

_____/_____/______

Home Address: ___________________________________________________________________________________

___________________________________________________________________________________

____________________________________________________________________________________

Home Phone #: ________________________________ Alternate Phone #: _________________________________

Building & Room Assignment: _______________________________________________________________________

Room Type: Double Single

By completing and submitting this form, you are consenting to be legally bound to your housing contract for one (1) full academic year. By signing this contract, you are consenting to the terms and conditions of the 2013-2014 Residence Hall

Contract, Policies and Procedures if you are granted on-campus accommodations. Completing this form does not guarantee you a space on campus. ALL STUDENTS ARE REQUIRED TO READ HOUSING CONTRACT IN THE

STUDENT HANDBOOK. For all students under the age of 18, parents are required to read the Residence Hall Contract and sign the Contract Acceptance Form.

My signature below certifies that I have read the Residence Hall Contract located in the Lincoln University Student

Handbook. I understand that I am responsible for adhering to the guidelines in the contract. I further agree to abide by University and Residence Life policies, regulations and financial obligations related to residing on the campus of

The Lincoln University.

_____________________________________________

Student Signature

_____________________________________________

Resident Hall Coordinator Signature

_____________________________________________

Parent’s Signature

_____________________________________________

Date

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