Housing Application

You must be admitted to AWC prior to completing this form.
Now Accepting Fall 2013 Applications.

Residence Life 2013-2014 Housing Information

Our Residence Halls are co-ed and provide suite style accommodations with on site student and professional staff dedicated to creating positive living and learning environments which promote academic success, cultivate personal development, and provide a comprehensive collegiate experience for a diverse population.

**2013-2014 Fee Schedule**

Please note, private rooms are offered on a space available basis for an additional fee ($549.00).

Residence Life Provides:

Bed & Mattress Desk & Chair Small Refrigerator One Phone Line (free local service) Basic Cable Toilet Paper

Shower Curtain Horizontal Blinds Chest of Drawers Two separate Internet Lines Microwave (in each lobby)

A laundry room is provided in each wing of the Residence Halls with washers and dryers at no additional cost to students.  Students must bring their own laundry detergent.

Students may want to provide their own:

Telephone Computer Television Bedding, Mattress Cover, & Mattress Pad Waste Paper Basket and Bags Plants/Posters to decorate

Laundry Basket & Laundry Detergent Cleaning Supplies (room/bath) Towels & Washcloths Ironing Board & Iron Alarm Clock, Radio, Lamp Refrigerator (less than 4.0 cu ft. & energy star efficient)

 Students may bring a hot pot, coffee maker, rice cooker, and blender. Appliances having a visible heating element or which use hot oil are prohibited.  Rooms are not equipped for cooking. NO ANIMALS, including fish, are allowed. Arizona Western College does not assume responsibility for lost, stolen, or damaged personal property. It is strongly recommended students purchase a Renter’s Insurance policy to cover their personal belongings.

 Arizona Western College reserves the right to assign students to residence halls and rooms and to consolidate as needs dictate. Please review the Residence Hall Application/Agreement for additional information.

STUDENT INFORMATION

I am 18 years old or older

If you are younger than 18 then you are ineligible for online submission, and must print the following Application

Name * Last Name First Name Middle Name Student ID *

Mailing Address * Number, street, apt... City AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY State Zip Country

Home Phone -- | Cell Phone -- | Email *

Date of Birth * Gender * M F  Semester applying for * Fall(Year) Spring(Year)

I am applying as a New Student Returning Student NAU Student* *NAU Students must provide copy of class schedule showing full time enrollment

Are you on an athletic scholarship? If so, which sport?

PARENT OR GUARDIAN AND EMERGENCY CONTACT INFORMATION

Parent or Guardian Name  |

Work Phone -- |

Home Phone -- |

Cell Phone --

In case of an emergency, please contact: * Same as Parent or Guardian

Full Name

Relationship

Home Phone
-- |

Work Phone
-- |

Cell Phone
--

I authorize 

(Full name and Phone Number)

 to take possession of my personal property in case of an emergency.

MEAL PLAN

Residence hall students are required to purchase a meal plan with their housing agreement at the cost of $1912 per semester. It is a declining balance meal plan for which the student is responsible for tracking and maintaining.

HOUSING PREFERENCE

Please check/rank (1-3) the housing preferences. Preference does not guarantee assignment. All three residence halls are co-ed with the exception of the all female and all male wings.

Residence Hall (Rank 1-3)
  DEANZA
  GARCES
  KINO

Wing (Rank 1-3) optional
  Female Only
  Male Only
  Go Green Wing

Any student who feels they may need an accommodation based on the impact of a disability should register with AccessABILITY Resource Services and request accommodations under the Americans with Disabilities Act or Section 504.

ROOMMATE PREFERENCE

In order for the roommate preference to be honored, both/all individuals MUST request each other (please use first and last name when requesting). Only roommate preferences that are received by July 1st will be considered.

Roommate 1

Roommate 2

PERSONAL INFORMATION

The following information assists in the roommate selection process (please answer for yourself)

In considert myself to be:
Morning person
Late night person
No preference

My room appearance is:
Very neat
Average
Messy

Smoker*
Non-smoker
*All rooms and buildings are non-smoking.

CRIMINAL RECORD

Have you ever been convicted of a felony or misdemeanor? (Other than a minor traffic violation)
YESNO (An answer of Yes does not automatically disqualify you for student housing.)

Do you have any pending charges?* YESNO

*Failure to disclose an incident will subject you to potential revocation of your on-campus housing.

 If yes to either question, you must submit the following to the Campus Life Office before your application will be processed: a cover letter stating what you learned from the incident, why you want to live in the residence halls, your educational goals, what your message to other students would be, what you are willing to do to be successful at AWC, and how we can help you do that. You must also submit a detailed summary of the offense from an appropriate judicial or corrections official, including copies of police reports, sentencing reports, court orders, probation paperwork, counseling release of information or other evidence satisfactory to the College.

Please list all pending charges or convictions (include date, classification, circumstance, location and current status):

RESIDENCE HALL LICENSE AGREEMENT

 

ARIZONA WESTERN COLLEGE

RESIDENCE HALL LICENSE AGREEMENT/CONTRACT

Terms and Conditions

 

This License Agreement serves as a binding agreement between Arizona Western College (hereinafter referred to as the College) and the Student (and parent or legal guardian, in the event said student is under eighteen (18) years of age) (also referred to as “resident”). The License Agreement is effective upon receipt of a complete application, $100.00 deposit and immunization record. 

The College hereby grants to the student permission to occupy a residence hall room as a licensee for the academic year indicated on the application, unless terminated sooner under the provisions of this License Agreement.

The License Agreement shall not be assigned, in whole or in part, and may be terminated by the College for any reason by giving no less than one-day’s written notice to the student.

The College and the student agree that no lease or any other interest in real property is created by this License Agreement.

 

1.        ELIGIBILITY

Before an application for residence will be considered, the applicant must complete and sign the Housing Application, of which this License Agreement are a part, pay the required deposit, and be cleared by AWC Health Services by submitting proof of immunizations. Students must enroll at the College and maintain a minimum of twelve (12) credit hours each semester. Students with less than twelve (12) credit hours may be subject to removal and are required to meet with the Coordinator of Residential Life within two (2) business days. The Coordinator of Residential Life will determine whether the student will be required to vacate the residence halls or sign an academic probation contract.

 

2.        CONTRACT TERM

This contract is for the academic year and cannot be terminated except under the conditions stated under item (11) TERMINATION OF LICENSE AGREEMENT/CONTRACT and item (18) VACATING. Occupancy periods will be limited from August 16, 2013 to December 12, 2013 at 5 pm for Fall Semester, and from January 10, 2014, to May 15, 2014 at 5 pm for Spring Semester, in all halls. Requests for early arrival and/or late check-out must be in writing no less than two (2) weeks in advance and be approved by the Coordinator of Residential Life. If the dates of the academic year are revised by the College, the revised dates will apply and will not change the financial obligations of this contract. Residential Life Office and the College further reserve the right to adjust opening dates each semester in order to adapt to the registration calendar of the College without any adjustment to rates.

 

3.        RESIDENT AGREES

Student agrees to make payment of all housing fees established by the District Governing Board according to the current payment schedule; to observe all rules, regulations and procedures as published in the Residential Life Handbook and the Student Code of Conduct which are by reference made a part of this contract and to honor the terms and conditions stated in this contract.

 

4.        RATES

A copy of current tuition and fees schedule is online at www.azwestern.edu/business_and_administrative/business_office/tuition_schedule.html.

These rates will be published no later than mid-May on our website: Campus Life > Housing and Dining > Rates and Important Info.

 

5.        PAYMENT SCHEDULE FOR ROOM AND BOARD

a)        Full room and board charges must be paid in advance for the occupancy period.

b)       Payment Plans may be arranged online through the student’s Web Advisor account.

c)        Arizona Western College may forward delinquent accounts to a collection agency.

 

6.        INDEBTEDNESS

a)        Students must ensure a complete financial aid package before move-in day. Students with an incomplete financial aid package must make arrangements to pay in-full or set up the authorized Payment Plan. The balance of any financial aid award will be applied toward the room/board account.

b)       Students that fail to make room and board payments on time or have delinquent accounts may be suspended from the Residence Halls. In addition, food service privileges may be terminated, the student will not be allowed to register for future classes, and transcripts will be held until the balance is paid in full. The student agrees to pay all attorneys’ fees and other costs/charges necessary for collection of any unpaid balances.

 

7.        ASSIGNMENT POLICY

The Residential Life Office (hereinafter referred to as the Office) will not discriminate in assignment to Campus Housing on the basis of race, color, creed, disability, age, ancestry, sex, national origin, sexual orientation, or gender identity and/or expression. New residents who return a complete housing packet will be placed on a waiting list based on the date of application and assigned as space is available. Residents are assigned to double rooms and share same-gender bathroom facilities. Students are permitted to have private rooms when the residence halls are not filled to capacity. The cost of a private room is 1 ½ times the regular room rate and must be paid in advance. Each student who desires a private room must consult with the Residential Life Office. Failure to honor assignment preferences will not void the contract. The Office reserves the right to cancel room or hall assignment, to assign roommates, or to consolidate vacancies by requiring the student to move from single occupancy of a double room to double occupancy of a double room.

The Residential Life Office reserves the right to temporarily assign additional residents above the design capacity of designated rooms until permanent space becomes available. 
Returning students are given first preference regarding roommates and room location. Assignment requests usually will be granted when space is available. The housing application is for space only and the College reserves the right to make changes in roommate assignments and room assignments when the College deems necessary.

 

8.        ROOM CHANGES

Students may change rooms only with prior written authorization from the Hall Director. Unauthorized room changes or failure to move out of a room at a designated time may result in being required to move back to their authorized assignment and/or disciplinary action.

 

9.        DEPOSIT

The room deposit is a guarantee against cancellation of the residential agreement, termination of residency prior to full semester payment, property damages and other possible charges that may accrue during residency. Although normally refundable, the entire room deposit, or a portion thereof as appropriate depending on the circumstances, is subject to forfeiture under the following conditions:

a)        Failure of the student to cancel the residence hall license agreement with the Residential Life Office by July 15^th for the fall semester or by December 12^th for the spring semester

b)       Failure of the student to claim his/her room by 5:00pm on the first day of classes

c)        Termination of residence by the student prior to the full semester payment of rent (10 weeks)

d)       Failure to follow prescribed checkout procedures when departing from the residence hall

e)        To defray the cost of damage to the residence hall caused by the student or damage to the room to which the student is assigned

f)        Breach of any of the terms and conditions of the License Agreement, including removal for disciplinary action

g)        To satisfy any other unpaid charges and assessed fees owed to the College documented through the Business Office/Cashier

h)       If you are eligible for a refund of your deposit you will receive it 2 to 4 weeks after the add/drop period of the following semester

 

10.     TERMINATION OF LICENSE AGREEMENT/CONTRACT

a)        Mandatory Termination – termination of this license agreement is mandatory if the student loses eligibility as defined in this contract under item (1) ELIGIBILITY

b)       Termination by the College – the Office may terminate this contract under the following circumstances:

(1)Exigency – the Office may terminate or temporarily suspend performance of any part of this contract without notice in the event of an exigency that would make continued operation for student housing not feasible or when the Residential Life Office believes a resident of a temporary assignment cannot be placed in a permanent assignment within a reasonable time period.

(2)Violation of Rules and Regulations – once a  student signs and returns the enclosed License Agreement, the Residential Life Office may terminate this contract if the student is found to have violated rules or regulations listed or referred to in this contract and/or in the Student Handbook or in the Residential Life Handbook. Disciplinary dismissal from the College or Residence Halls will subject resident to a full charge of their room and board and a forfeiture of their deposit.

(3)The College reserves the right to deny or cancel a License Agreement/Contract for College provided housing to an individual whose conduct and/or proven criminal record indicates a potential threat or danger to the College community including students, faculty, and staff.

(4)Failure to Comply with License Agreement – if student fails to comply with any portion of this contract or a prior contract held with the Office, the Office may terminate this contract with an appropriate notice. The Office may also terminate this contract if student has unpaid charges from a previous Residential Life Contract.

(5)The College may terminate this contract upon the student’s failure to pay fees in advance, with revocation effective as of the last day covered by prior payments.

 

11.     RELEASE, REFUND AND FORFEITURE PROCEDURE

a)        During Contract Term – if a student does not check-in to their room by 5:00pm on the first day of classes and has not notified the Residential Life Office in writing that they will be arriving late they will be automatically purged out of the system and the deposit will be forfeited.

b)       Refunds to students departing from the residence halls prior to the end of the semester are computed on the following basis: Students forfeit their room deposit and will be charged 10% of the total semester rate for each week or partial week of registered occupancy beginning with the day the residence halls open. After 10 weeks of room occupancy, a student is not entitled to any refund for room and board. The total rent charges shall not exceed the semester rate except when added charges are assessed for losses and/or damages to College property.

 

12.     LICENSE AGREEMENT/CONTRACT ASSIGNMENT

This contract cannot be assigned by the student to another person. Student may not sublet any part of the premises.

 

13.     LIABILITY

The District Governing Board of the College, its officers, employees and agents has no legal obligation, nor any ability to provide reimbursement for student’s personal property result from loss, theft, water or fire damage, vandalism, or any other perils.

Accordingly, student agrees to hold harmless and indemnify the District Governing Board, the College, the Office and its officers, employees, and agents, for damages sustained by student him/herself or others, as a result of their acts or omissions, relating to any changes of modifications made by student to their room or furnishings, such as the construction of loft beds, bunk beds, bookshelves, partitions, or other structures. This means that student is financially responsible for injury to another party, or damage to their property, as a result of any equipment or items student has constructed, created, purchased or used improperly, and that student will pay any resulting claims on behalf of the College.

 

14.     DAMAGES AND COSTS

Student agrees to pay for any damages to the building, including fire damage, and for damaged or missing furniture, lost property, or service costs caused by the student to the Residence Halls because of his/her negligent actions or intentions. Where two or more residents occupy the same room and responsibility for damage or loss in the room cannot be ascertained by the Office, the cost of damage or loss will be divided and assessed equally between or among the residents of the room/suite. The Office reserves the right to assess common area damage between residents of the hall/building/area.

 

15.     VACATION PERIODS

Students may not occupy their rooms later than 24 hours after their last final exam of the semester. All buildings remain open during Thanksgiving and Spring Break. All buildings will be closed during Winter Break, and all services normally provided will be discontinued.

 

16.     FOOD SERVICE

All residents are required to purchase the Declining Balance Meal Plan. The last day of food service each semester will be the same day that the Residence Halls close. There is no refund for unused monies on students’ ID cards. There is no food service during Winter Break. The weekend meal schedule will be observed on school holidays.

17.     VACATING
Student will vacate the premises within 24 hours after termination of this contract, discontinuance as a student or their last final exam of the semester, whichever occurs earliest. If the student is graduating from the College, they may remain in their room until noon the day following Commencement Day.

 

18.     CHECK-IN AND CHECK-OUT

Upon moving into the assigned room, the student should complete, sign and turn in a Room Condition Report within 24 hours, which will be an accurate and complete record of the contents and condition of the room. When vacating the room, student must schedule a check out with a Resident Assistant (RA), make sure their room is clean, and turn in their room and mail keys. The Check-Out Form, Room Condition Report, plus a room inspection by the RA, will serve as the basis for check-out charges or refunds as appropriate. If you are registered in only late-start classes you may check-in to the Residence Halls beginning the Thursday prior to the first day of class.

Student agrees to follow the proper check-out procedures when vacating the premises, which include returning their keys to the RA, removing personally owned belongings and furniture, waste and debris, rearranging the room furniture to match that of the condition at the move-in, and leaving the room in an acceptable, clean condition. Should extra cleaning or furniture rearrangement/reassembly by the College personnel be required because of the student’s poor housekeeping or failure to rearrange the room, a service charge will be added to the resident’s account. In the event of contract termination, the student’s failure to checkout according to the required procedures and timelines may result in a fee for a lock change being assessed to the student’s account.

 

19.     ROOM ENTRY AND MAINTENANCE OF PREMISES

The College and the Office reserve the right to make repairs or improvements to the facilities and residents’ rooms during occupancy periods. The College shall provide twenty-four (24) hours advance notice to the student, whenever possible. In case of emergency, or when two days notice is not feasible, the College reserves the right to enter premises without student’s consent and/or advance notice. Authorized personnel may enter student room for serious life- or health-threatening emergencies at any time including over break periods. Authorized personnel may enter a student room to perform requested, preventive, prescheduled, or emergency maintenance, or, in the absence of occupants of the room, to silence a disruptive noise. When possible, twenty-four (24) hours advance notice of room entry will be given. The College employees are required to report any violations of the terms of this contract they may observe when in the room. The College reserves the right to search a room if there is reasonable cause to believe that the search of that room will reveal evidence of an illegal act or College policy violation. Health and Safety/Room Checks will be conducted on a regularly scheduled basis. Property can be seized and removed from student room when it constitutes an imminent danger, when it is deemed illegal, when it is College-owned property, or when staff has found an unauthorized pet in the room. Student agrees to make no alteration to the housing facility without the written permission from the College. Any structural addition or alteration is prohibited without written permission from the College. Student further shall not possess any highly flammable material, firearm, ammunition, fireworks, explosives, bb device, dangerous weapon, any type of sling shot device, paint ball gun, or any other material or instrument which, in the opinion of the College authorities, pose an unreasonable risk of damage or injury.

Student agrees to be jointly responsible with other residents for protection of the common area furnishings, equipment, and facilities. Damage or loss of common area furnishings unless specifically assigned to individuals shall be equally divided among all members of the living group who have reasonable access to the common area.

 

20.     PERSONAL PROPERTY AND ABANDONMENT

The Office shall, without liability, have the right to donate, destroy, or discard of any personal property left or abandoned on the premises ten (10) days after the end of this contract term. During such 10-day period, the College, Governing Board, the Office, and its officers, employees, and agents will not be responsible for loss, damage, or theft of the property.

 

21.     CONTRACT CHANGES

Changes may not be made in the terms and conditions of this contract without the agreement and written permission from the Coordinator of Residential Life.

 

22.     ENHANCEMENT OF EDUCATION EXPERIENCE

The College shall maintain a professional staff to work with students to develop a community concept within the housing facility to enhance students’ education experience at the College. The facility shall be operated to enhance the social, educational, and recreational experiences available to the student.

Student agrees to recognize the importance of maintaining the Residence Halls as an environment that is conducive for fellow students to study, live, and sleep. Student agrees not to disturb this environment.

 

23.     INSURANCE

a)        During the period covered by this license agreement, student is highly encouraged to obtain health and accident insurance, on either an individual or group basis.

b)       The College has no insurance to cover the personal or property damage of the student. Therefore, the College highly recommends that the student obtain insurance, such as renter’s policy.

 

24.     NOTICE OF EVICTION/REMOVAL

Notice of eviction/removal shall be served upon the student or be posted in some suitable place upon the housing facility of the student.

I have read, understand and accept the terms of this Residence Hall Application/Agreement, Residence Hall Conditions of Residence and the Residence Hall Community Standards. I understand that any violation of College policies outlined in the Behavioral Code of Conduct, Residence Life Community Standards, Student Handbook and College Catalog may result in disciplinary action up to and including termination of this agreement, which would result in expulsion from the residence hall and/or expulsion from the College along with forfeiture of deposit. I accept financial responsibility for the full agreement period that I have stipulated above.