Housing Form Name* First Last Preferred name Student ID Number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneCell Phone*Date of Birth* MM DD YYYY Email* Gender*MaleFemaleHigh School Graduation DateHigh SchoolHometown/StateReligious affiliationParent's/Guardian's nameTerm you plan to enroll at HLGU*Spring 2021Fall 2021Spring 2022Classification*New freshmanTransfer studentDo you plan to live on campus or off campus while attending HLGU?*On CampusOff CampusGrade LevelFreshmanSophomoreJuniorSeniorCredit Hours CompletedTotal Accumulated HoursWhich colleges/universities have you attended?At your previous college/university, did you live in campus housing?YesNoApplication for Conditional On-Campus ResidenceThe HLGU Office of Student Life cannot guarantee your first choice of residence hall, but requests will be honored WHEN POSSIBLE. Requests will be processed based upon the receipt of this application, the $100 housing deposit, and availability of resident hall space. The following information will be used WHEN POSSIBLE in the assigning of rooms and roommates. Please check the appropriate box on the following questions.How do you like to study? Alone With others How would you classify yourself? Morning person Night person Both Neither What type of music do you enjoy? Variety Country Praise/Worship Rock Pop/Top 40 Alternative Christian Gospel Classical Jazz Rap/Hip Hop Alternative Contemporary Christian Other Would you be interested in living with a student from a different cultural or regional background?YesNoNo preferenceHow do you prefer to keep your room?NeatMessyCasualWhat is your birth order in your family?OldestMiddleYoungestOnlyIntended MajorWhat activities or sports do you intend to participate in at HLGU?Church activitiesPrevious school involvementHobbies/OtherResidence hall preferenceKleckner (female)Lewis/Brown (female, extra charges may apply)Fletcher (male, extra charges may apply)Crouch (male)Roommate Preference (Optional)Roommate requests must be mutual and in writing.First choice name First Last HometownSecond choice name First Last HometownPrivate room request I am requesting a PRIVATE ROOM with the understanding that an additional charge is involved and that a limited number of private rooms are available.What other information should be considered in the assignment of your housing and/or roommate? Please include any special medical and physical needs.Can we share your contact information with your roomate? If so, please list your preferred form of communication.Off Campus InformationEligibility Criteria*All unmarried students enrolled in eight or more hours must reside in university housing except students who meet certain criteria. Please select the criteria below that you meet for living off campus. Please be aware that the housing office will be in contact with you regarding the status of your off-campus application. To learn more about HLGU's on-campus living policy, you may locate information in the resident life handbook. I live with my Parent/guardian. I have employment for which payment is or includes housing. I have attained the age of 21 or shall during the semester. I have attained senior status (minimum of 90 credit hours) prior to the semester for which the request is made. YOUR SIGNATURE: In case of illness, emergency, or accident, Hannibal-LaGrange University is granted the right to request treatment of or admit the student to the appropriate facility.*I certify that the information given is correct to the best of my knowledge. I will observe HLGU residence hall regulations on conduct and policies under which residence halls are operated. Further, I understand that the acceptance of this form and reservation deposit does not guarantee admission to the University or into the residence hall. I also understand that upon admission to the University, I will be responsible for paying all rent charges together with all other applicable charges due under this contract. I understand that room reservation cannot be made until the residence file is complete. I understand that room and roommate availability is determined by the availability when the resident file is complete. Hannibal-LaGrange University is a Christ-centered, educational community. Communities function best when their members understand and abide by established standards of lifestyle and conduct. Therefore, while attending Hannibal-LaGrange University, students will maintain a lifestyle based on biblical standards of conduct. Failure to do so may result in a reprimand or, in some cases, dismissal from the institution. It is the goal of HLGU that each student has a lifestyle where "...Christ might have the pre-eminence." Col. 1:18. I agree to adhere to and support the following principles (on or off campus): 1. I will be loyal to the mission of Hannibal-LaGrange University as a Christ-centered institution affiliated with the Southern Baptist Convention. 2. I will not engage in the use, sale, or possession of alcohol or the production, possession, use or sale of illegal drugs. 3. I will reject as acceptable all sexual activity not in agreement with the Bible, including, but not limited to, premarital sex, adultery, and homosexuality. Hannibal-LaGrange University is committed to an approach to sexuality and moral purity that reflects biblical values. We believe that premarital sex, extramarital sex, and homosexual acts violate clear biblical teaching on sexual purity. Behavior that is inconsistent with these standards is prohibited even when consensual. Sexual activities outside of marriage, including sexual intercourse, oral sex, and other intimate forms of touching, are prohibited. Consistent with our desire to teach and model a biblical approach to sex, the University also prohibits same-sex dating. Hannibal-LaGrange University has established other rules and regulations necessary for orderly community life and has listed them in the student handbook. You will find information which further explains the specifics of the behavioral expectations above in the section of the student handbook on HLGU's policies I declare that I am in agreement with the statements above. My submission of this form indicates that I meet the moral integrity standards and Christian role model lifestyle requirements of HLGU.