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Housing Application

Contact Information

First Name

Last Name

Hocking College Email Address

Confirm Hocking College Email Address

Address Line 1

Address Line 2

City

State

ZIP Code

Preferred Phone

Home Phone

Cell phone

Housing Information

Gender

First Building and Room Preference

Secondary Building and Room Preference

Third Building Preference

Do you have a preference in roomate?YesNo

Roommate Name

Do you require an emotional support animal or service animal?YesNo

Preference on Roommate with Support Animal?YesNo

Have you received your Meningococcal Meningitis Vaccine?YesNo

Meningococcal Meningitis Vaccine Date

Have you received your Hepatitis B VaccineYesNo

Hepatitis B Dose 1 Date

Hepatitis B Dose 2 Date

Hepatitis B Dose 3 Date

Comfortable with LGBT?

Personality Type

Additional Rooming Information

Have you ever been charged, indicted, or convicted of a felony?YesNo

Explain conviction or disciplinary action

If you have selected Yes for either question above, please give the approximate date of each incident, explain the circumstances, and reflect on what you learned from the experience.

Housing Application Submission

By submitting this Housing Application, I certify a $60 non-refundable Residence Life Housing Application fee will be assessed on my account. I also certify a $250 Housing Security Deposit will be assessed on my account.

Semester I plan to take classes:

Academic Program

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