Hillsdale College - Housing Form

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** Attention: Please do not submit this form if you have already done so via mail.**

This form is to be completed by all students, whether or not they will be residing in College housing.
The deposit of $200.00, to be credited to the student's account, assures each person a dormitory reservation where applicable. Reservations are determined by date of deposit.
All student's, except those who are married or living with relatives in the area, must live in College residences if space permits. Please refer to the Hillsdale College Catalog for additional guidelines.

General

First Name:
Last Name:
Home Address:
City:
State:
Zip:
Telephone:
Cell Phone:
E-mail:

Father:

Full Name:
Occupation:
Home Address:
City:
State:
Zip:
Business Phone:
Cell Phone:
Email:
Birthplace:
Secondary School Attended:
Graduated?
- Yes
- No
College Attended:
Degree?
- Yes
- No

Mother:

Full Name:
Occupation:
Home Address:
City:
State:
Zip:
Business Phone:
Cell Phone:
Email:
Birthplace:
Secondary School Attended:
Graduated?
- Yes
- No
College Attended:
Degree?
- Yes
- No

Personal Information:

Birthplace:
Birth Date:
Height:
Weight:
Veteran:
- Yes
- No
Church Preference:
Do you smoke?
- Yes
- No
Do you mind if your roommate does?
- Yes
- No
Secondary School Attended:
Date of Graduation:
Scholastic Rank in Secondary School:
- Upper Third
- Middle Third
- Lower Third
Other Colleges and Dates Attended:
Favorite Subjects:
Future Vocational Aim:
College Program Intended (majors and minors):
Organizations to Which You Belong / Extracurricular Activities in Secondary School:
Interests and Hobbies:
Work Experiences:
Foreign Countries Visited:
Roommate Desired (description or name):
Dormitory Preference:

If Transferring From Another Institution

Did You Participate in Rushing?
- Yes
- No
Were You a Pledge?
- Yes
- No
When?
Date of Initiation:

International/Out-of-State Students: It is important that international and out-of-state students take note of the following requirement of the College in order to eliminate future anxieties. All students must plan to provide for their room and board during the regular vacation time and between semesters. The College does not provide facilities for housing and board during this period. An additional sum of money should be allotted specifically for this purpose.

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