Student Accommodation Application

* indicates a required field

Student Information

Please enter your information
*
*
*
Please use your Bruinmail email address
Date of Birth(Required) *
Please enter your phone number in this form (xxx) xxx-xxxx
*
Military/Veteran(Required) *
Are you being sponsored by



Do you have internet services available to you at home?
***Please list all technology you use, so we can set up your accommodations accordingly.***
Were you in special education classes or resource classes
*
*