A branch of Webber International University
Did you know...
Academic programs offered range from Business, Sports Studies, Biology, and Forensics to Creative Writing, Psychology, Education or Philosophy as well as Pre-Professional Programs.

St. Andrews New Student Residency Contract
Prior to completing this form, make sure to read
Housing/Food Services Statement of Terms and Conditions of Occupancy.

Personal Information
Semesters Attending
Academic Year 2013-2014		 Fall Spring
Incoming Class Rank: Freshman Sophomore Junior Senior
First Name:
 MI Last
E-mail: 
Gender:
 Male:   Female:    
Social Security #:
  
Date of Birth:
Home Phone:
  
Student Cell Phone:
  
Home Address:
     
City:
 State Zip
Parent/Guardian1:
Work:
Cell:

Email:
 

Parent/Guardian2:
Work:
Cell:

Email:
 

In Case of Emergency Contact  
Name:
    Phone:
Relationship to you:
Cell Phone:
   

Please Note:

*New students who are 26 years or older require permission from the Dean of Students to live on campus. Permission is granted only in special circumstances.

*All incoming new students are also required to complete the New Student Housing Survey unless they make a roommate assignment request at the bottom of this form.

 

Residential Student

Special Housing Needs: Students with medical or disability-related housing needs must complete the Disability Assistance eligibility process, and document their specific needs with the Director of Disability Services (910) 277-5667.
I will need special housing arrangements.
I will not need special housing arrangements.
   
Telephone Request: Please designate whether you would like St. Andrews to provide a Cisco VOIP landline phone in your residence hall room. If you decide to have a landline phone, you must agree to set up the voicemail. We will only provide one phone per room.
I want St. Andrews to provide a Cisco VOIP landline phone in my residence hall room and agree to set up the voicemail.
I do not want a CISCO VOIP landline phone in my residence hall room. I will use my cell phone number as my phone contact.
I want to receive campus emergency text notifications on my cell phone.
   
Roommate Assignment Request: If you already have identified a person with whom you wish to live, please complete the following:
Name of requested roommate:
Important Note: Both students must request each other and submit their contracts before the assignment can be finalized.
   

Agreement

Residential Student Agreement: I request that the college proceed to assign room and board accommodations in keeping with the terms of this contract.

 

I acknowledge that by submitting this form, I am providing an electronic signature verifying that the information is correct as submitted and an accurate reflection of my consent as indicated above. I further verify that I have reviewed and understand the Housing/Food Services Statement of Terms and Conditions of Occupancy.

© 2012 St. Andrews University. All Rights Reserved.
Access Webmail
Access Moodle
GoodSearch: You Search...We Give!

St. Andrews University
A branch of Webber International University
1700 Dogwood Mile
Laurinburg, NC 28352
(910) 277-5555 • (800) 763-0198 • (fax) 910-277-5020