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Online Housing Application

Two easy steps to register
In cases where a shared living environment may negatively impact a student’s health or well-being due to their disability, a private room may be provided. This accommodation is only granted when a Qualified Licensed Health Professional deems it medically necessary and as the only option to maintain the student's health and well-being.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 9 alpha numeric characters.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information

Questions

  1.  
    What housing Accommodation (s) are you petitioning for
  3.  
    I have met with my Qualified Health Professional as described above and have uploaded my documentatation * (Selection is Required)
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