Student Accommodation Application

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Student Information

Please enter your information
Please use your Bruinmail email address
Date of BirthRequired
Please enter your phone number in this form (xxx) xxx-xxxx
First Generation Student
Pell Grant Eligible
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
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