Housing application

Date you plan to move in:

Month Day Year(YYYY)

Date you plan to move out:

Month Day Year(YYYY)

Last name:

First name:

Middle name:

Present Address

Address:

City:

State/Province:
(

if U.S. or Canada)

Zip/Postal code:
(

if U.S. or Canada)

Country:
(

if non-U.S.)

Phone number (with area code):

Permanent Address

Check if same as above

Address:

City:

State/Province:
(if U.S. or Canada)

Zip/Postal code:
(if U.S. or Canada)

Country (if non-U.S.):

Phone number (with area code):

Cell Phone (with area code):

Check if you do not have a cell phone

Personal Information

Curriculum to which admitted:

Country of citizenship:

Birth date:

Month Day Year(YYYY)

Religious affiliation:

E-mail address:

Emergency Contact (other than yourself)

Contact name:

Phone number (with area code):

Preferences

As there are only about 30 single rooms, they are in high demand. Due to this demand, all students must enter into a double occupancy space. After entering Lindsay you may request to be put on the waiting list for a single room. It is usually a 1 1/2 to 2 year wait.

Although no guarantees can be made, the priorities listed in this section will be honored whenever possible. Housing applications remain active for six months. Students whose applications have expired relinquish their assignment priority and must submit a new application.

Choice of Roommate:

How neat and clean do you keep your room?

My room is ALWAYS neat and clean
My room is neat and clean MOST OF THE TIME
My room is neat and clean SOME TIMES
My room is NEVER neat and clean

Describe your sleep schedule:

Go to bed early; sleep late
Go to bed early; get up early
Go to bed late; sleep late
Go to bed late; get up early
No bedtime preference

Preferred roommate age?

Roommate under 21 years of age
Roommate over 21 years of age
No roommate age preference

Describe your study schedule:

Study early in the evening
Study late at night
Study early in the morning
No study time preference

Music preferences:

Other Information

Hobbies:

Do you sing?

Yes No

Instruments you play currently:

Church-sponsored activities in which you have engaged in the past 5 years:

Send $200.00 check for room deposit to:
Checks/money orders should be made payable to Lindsay Hall. Credit card payments are not accepted.

Lindsay Hall
Loma Linda University
Loma Linda, CA 92350

You will not be roomed until we have received your deposit (check or cash only).

Notice of cancelation of reservation must be received no later than two weeks prior to stated arrival date.

Refund of room deposit
A $50.00 processing fee is assessed on each deposit.

Your room deposit (all but the $50.00) will be refunded under the following conditions:

Notice of cancelation of room reservation is received at least two weeks prior to your stated arrival date.
You give a two week written notice to the Dean of planned departure.
You leave your room clean and undamaged.

Refund of room license fee:
Room license fee is charged by the quarter (12 weeks) and is NOT refundable. Extenuating circumstances will be considered. In all cases, residents shall provide at least 2 (two) weeks written notice to the residence dean in the event termination of this license agreement is required. Should less than two-weeks notice be given, an additional charge will be applied.

Address:
Kate Lindsay Hall
Loma Linda University
24898 Sanitarium
Loma Linda, California 92350

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