All new single students (commuters or on campus) must submit this form to complete your admissions file. In addition, students must submit their $100 enrollment deposit in order to have a dorm assignment made and be allowed to register for class.

Note: Fields marked with * are required.

*Select the term and year you plan to enroll at ETBU: *Year:

GENERAL INFORMATION

*First Name: *Middle Initial: *Last Name:

*Phone Number: Cell Phone:

*Social Security Number: *Sex :

*Address:

*City: *State: *Zip:

*Birthdate: ,

*I will enter ETBU as a:
¹If transferring from another school, how many hours will you have completed when you enroll at ETBU?

Parent or Guardian Information:

*First Name: *Last Name:

*Address:

*City: *State: *Zip:

*Home Phone: Work Phone:

HOUSING GUIDELINES


*Select One:
 I am under the age of 25 and plan to commute to ETBU and not live in on campus (Commuting distance must be within 60 miles of Marshall).
 Complete Section A below.
 
 I am applying for single student housing on campus.
 Complete Section B below.
 
I am 25 or older and will be living off campus.


SECTION A Only fill this section out if you are planning on commuting and not living on campus.

*Select One

 I request permission to live at home with my parent. (If approved, you will receive a letter of notification granting you permission to live off campus.)

 I am independent based on the FAFSA criteria and request permission to live off campus. (This must be verified by the Financial Aid Office.)

 I am between the ages of 21 and 24 and request to live off campus and will not be living with a parent. I understand that I am not eligible for ETBU scholarships.

SECTION B Only fill out this section if you are planning on living on campus.

*Do you have a specific student you would like to request for your roommate?
Yes
No
(PLEASE NOTE: Forms and Enrollment Deposits for both roommates must be submitted by the May 1 deadline to guarantee your selection. New students might not be assigned to room with current students, depending on the classification and number of hours completed by each student.)
     Name of requested roommate:

He/She is a:
current student
new student

*If space permits, would you prefer a private room at an additional charge?
Yes
No
(This request can only be granted if space is available)

*Check below if you would like to broaden your multi-cultural experience by having an international student as your:
Roommate
Suite Mate

If you are transferring from another college or university please list the last college attended below:
School:

*Special Needs:
The ETBU Division of Student Affairs is committed to providing the highest degree of service to students. In an effort to assist you, prior to your arrival on campus, please share any information regarding special needs or concerns that you may have, such as: physically challenged, mental disorders, special medical needs, etc.


In order to help us select a roommate best suited for you, please fill out the information below:

*Which best describes your style of housekeeping?
Neat
Moderate
Messy

*Which types of music do you prefer to listen to?
Christian
Country
Classical
Rock
Other

*Which best describes you:
Leader
Follower

*Which best describes your sleep habits?
Bed early/rise early
Bed late/rise late
Bed late/early rise
Bed early/rise late

*When do you prefer to study?
Morning (9am-12pm)
Afternoon (1pm to 5pm)
Evening (6pm to 10 pm)
Late (10pm - ?)

*Check the one quality that you feel is most important in a roommate:
Outgoing and social
Academically oriented
Athletic
High morals

*How many siblings do you have?
*Have you ever shared a room?
Yes
No

*Do you plan to be on an ETBU athletic team?
Yes
No
If so, which one:

*Provide any additional comments that would help us place you with a roommate:


I understand that there are rules and regulations regarding student housing at East Texas Baptist University and I agree to read, understand and abide by all rules as outlined in the catalog and student handbook.