Animal Friendly Application

Name*

First Last

Student ID Number*

Degree Program*

Application Type*

Date of Birth*

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Gender

Housing is needed beginning which semester?*

Year*

Desired Move in Date

Are you an international student?*

Do you need a furnished unit?

Marital Status*

Single

Married

Engaged

Fianc茅鈥檚 Name

First Last

Wedding Date*

Spouse's Name*

Children

Name

Date of Birth

Gender

Additional Requests

Do you have any health concerns, special requests, or accommodation requests? NOTE: If so, the housing office will contact you regarding additional paperwork.

Pet Information

Please review the .

Pet's Name*

Attach Photo of Pet*

Max. file size: 128 MB.

Type/Breed*

Age of Pet*

Sex*

Weight*

Anticipated full-grown weight*

Pet Documents

Drop files here or

Max. file size: 128 MB.

Please attach most recent rabies vaccination, shot and spayed/neutered records in compliance with Kentucky law.

Pet Reference

If you are not already settled in the Wilmore area, please provide us with the most up-to-date information regarding your pet鈥檚 veterinary information and emergency caretaker. This information must be updated with the housing office if any changes are made upon moving.

Veterinarian Name and Clinic Name*

Vet/Clinic Address*

Street Address Address Line 2 City State ZIP Code

Vet/Clinic Phone*

Pet Emergency Caretaker

Emergency Contact - Name*

First Last

Emergency Contact Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact Phone*

Relationship to Lessee*

Finalize Application

I understand that this is a contract. I understand that after my Housing Application and Deposit have been received, I will be placed on the housing wait list, but without guarantee of assignment. I also understand that this deposit will become part of the security/damage deposit when I occupy Seminary housing. If Seminary housing is not available for the term specified above and I do not wish to remain on the priority list for future assignment, I may request a refund. If I accept, but then decline, the Seminary housing offer, or if I do not show up for my reservation, then the deposit is forfeited.

I understand my agreement to reside in campus housing at 番茄影视 requires my primary campus be assigned to the Wilmore, Kentucky campus, and my campus housing address be listed as my correspondence address in my student records.

Signature*

Enter your full name to indicate read and agree with the terms of the contract.

番茄影视

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