Housing Application

Housing applications are considered ONLY after a student has been accepted into a Southeast Tech program. If you have questions about that process, contact your Admissions Representative. Incomplete applications may not be considered for Housing.

Are you an accepted student at Southeast Tech?: *

 
Last Name: *
 
First Name: *
 
Middle Name:
Email: *
  
Street Address: *
 
City: *
 
State: *
 
Zip Code: *
 
Southeast Tech Student ID Number: *
 
Home Phone:
 
Cell Phone: *
  
Birth Date (MM/DD/YYYY): *
  
Gender: *
 
Field of Study: *
 
Please select the Academic Term that you wish to begin living in Housing: *
 
Roommate Preferance (if any)
Full Name of Roommate Preference #1:
Full Name of Roommate Preference #2:
Full Name of Roommate Preference #3:
Hall Preference: *
 
Emergency Contact Information
Please provide the following information to be used in the case of an emergency situation (i.e. parent/guardian)
Last Name: *
 
First Name: *
 
Relation to Student: *
 
Home Phone:
 
Work Phone:
 
Cell Phone: *
  
Special Accommodations/Other Information
Do you require special accommodations for Housing placement?*: *
 
If yes, please explain:
*All accommodation requests based on medical/special circumstances require official documentation from required personnel to be filed with Southeast Tech.
Are you currently, or have you ever been, required to register as a sex offender?**: *
 
Are you currently under investigation, been convicted, pled guilty, entered a no contest plea, or received a suspended imposition of sentence of a felony?**: *
 
**If you answered "Yes" to either of the questions above, please provide a detailed explanation: