EmailMeForm
Housing Reservation Form
Enrollment status
*
New Freshman
New Transfer
Readmit
Returning
Graduate
(Freshman and sophomore students must live on campus unless they meet criteria outlined in the Housing Waiver Application.)
Semester Enrolling
*
Fall
Spring
Year Enrolling
*
Student Information
Shaw Student ID #
*
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Name
*
First
Middle
Last
Suffix
Email
*
Permanent Mailing Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Primary Phone
*
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Mobile Phone
*
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Parent/Guardian Name
*
First
Last
(This information will also be used as Emergency contact.)
Contact Phone
*
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Roommate Request
Roommate pairing is done randomly, however, if you have a roommate request, we will try to honor it. Both parties must request the other person on their housing application and submit housing reservation form and non-refundable fee by the deadline for the semester applying. Specific rooms may not be requested.
Name
First
Middle
Last
Student ID #
(Student ID of requested roommate)
Do you have medical concerns that we should be made aware of prior to assigning your room for the semester?
*
Yes
No
Please state medical concerns/issues?
*
Documentation from a health care provider must accompany any requests for special accomodations at the time of application.
Do you smoke?
*
Yes
No
Please note that smoking is prohibited in the residence halls.
Are you currently a member of a Shaw University athletic team, Platinum Sound Marching Band or Honors College?
*
Athletic Team
Platinum Sound Marching Band
Honors College
None
Please select all that apply.
Which sport do you play?
*
Are you currently 18 years or older?
*
Yes
No
Application certification
*
I certify that all information provided is true to the best of my knowledge
Student Digital Signature
*
First
Middle
Last
Suffix
Parent Digital Signature
*
First
Middle
Last
Suffix
Required if student is under 18 years of age at time of application
Payment Options
*
Submit Secure Online Payment via Debit/Credit Card
Payment Previously Submitted
Payment Transaction Number
Date Time
MM
/
DD
/
YYYY