University Park Student Housing Application

All information with a red label is required.

Applicant Information

First
MI
Last

Permanent Home Address

Street

City

State

Zip/Postal Code

Province/Country

Home Phone

Cell Phone

Date of Birth

International Student

SSN

Student ID

Identifying Gender (for purposes of assignment to gender-specific housing only) Male Female

E-mail Address

School E-mail

Personal E-mail

Choose the email address you prefer to receive information and will use for the resident portal:

School Personal

How did you hear about University Park?

School Information

Major:

Currently Enrolled in College

Expected Move In

At the time of desired move in, I will be a(n):

Are you a student athlete?

Fall/Spring sport?

Expected Graduation Date

Guarantor Contact Information

*A guarantor must be a person over the age of 24, usually a parent, who agrees to be responsible if you are ever unable to fulfill the financial obligations of your license agreement. It is similar to having a co-signer. Please provide the information below for the person who you expect to serve as your guarantor.

First
MI
Last

Home Phone

Cell Phone

Work Phone

E-mail

Same as Permanent Home Address

Street

Street2/Apt

City

State Zip

Emergency Contact Information

First
MI
Last

Home Phone

Cell Phone

Work Phone

E-mail

Same as Permanent Home Address

Street

Street2/Apt

City

State Zip

Roommate Information

Please list preferred roommates (max of three):

First Last Email Phone

My preferred license term is:

*2x2 and 2x1 units are offered in Annual Terms only. 4x2 and 4x4 units are offered in both Fall/Spring and Annual Terms.

Term:

My preferred apartment style is:

1st Choice:

2nd Choice:

3rd Choice:

Preferences

The following information will be used for roommate matching only. Please complete this section as if you were talking to a prospective roommate and keep in mind that your honesty will benefit both you and your roommates. Check all items that apply.

Smoking:

I smoke I do not smoke

Note: University Park is a smoke-free community; smoking is limited to designated outdoor areas.

Drinking

I drink I do not drink

On most weeknights I:

Watch TV
Study
Listen to Music

Entertain Friends
Go Out
Work

On most weekends I:

Watch TV
Study
Listen to Music

Entertain Friends
Go Out
Work

Studying:

Where I Study	How Much I Study	When I Study
I prefer to study in my bedroom	I study less than 1 hour/day	I prefer to study in the morning
I prefer to study in the living room	I study 1-3 hours/day	I prefer to study in the afternoon
I prefer to study at the library	I study more than 3 hours/day	I prefer to study at night

Other people consider me to be:

Immaculately Clean [1]

Very Messy [5]

Your selection:

Extremely Quiet [1]

Really Outgoing [5]

Your selection:

Morning Person [1]

Night Person [5]

Your selection:

Are you interested in living in a gender inclusive apartment? Yes No

I am active in the following activities and organizations:

Special considerations or accommodations, including allergies or dietary restrictions:

I like to keep the apartment temperature: 70 or below 70 to 75 75 or above

By checking this box, you give us permission to release any roommate matching preferences/information included on the application to roommates/potential roommates. You also understand that these preferences are taken into consideration, not guaranteed, when assigning your apartment.

CRIMINAL HISTORY

Have you ever been convicted of and/or pled "guilty" or "no contest" to any felony regardless of whether such action resulted in jail or prison time served and/or deferred adjudication?
Yes No

Have you ever been convicted of and/or pled "guilty" or "no contest" to any misdemeanor involving theft, burglary, pornography, physical assault, indecent exposure, sexual misconduct and/or any unlawful conduct involving a minor, regardless of whether such activity resulted in jail or prison time served and/or deferred adjudication?
Yes No

Are you currently on probation, parole, or suspended sentences for any of the above?
Yes No

Terms and Conditions

COCM supports the Fair Housing Act as amended, prohibiting discrimination in housing based on race, color, religion, sex, national origin, handicap or familial status. COCM follows the standards below, including but not limited to: We do not accept prospective residents currently on parole, probation and/or suspended sentence for any conviction, or who have been charged with, pled "guilty" or "no contest" to, and/or convicted of any felonies, certain misdemeanors, or any unlawful conduct involving a minor.

CITIZENS:

Complete a standard application form and license agreement package.
Obtain an approved guarantor.
A parent or sponsor guarantor is required sign a Guarantor Agreement and must be at least twenty-one years of age.

NON-CITIZENS:

Complete a standard application form and license agreement package.
Provide a passport.
I-20 verifying student status and proof of enrollment or appropriate work visa verifying country of origin and length of employment

GUARANTORS:

The guarantor must be at least 24 years of age and preferably a family member.
The guarantor must reside in the United States.

Applicant understands that to secure use of a bedroom within an apartment, he/she must complete all Lease Agreement paperwork and pay all fees. Applicant understands that if, at any time, there are vacant bedrooms in the applicant's assigned apartment, Capstone On Campus Management (COCM), as Agent for MEDCO (Maryland Economic Development Company), reserves the right to assign roommates without prior notice and/or relocate the applicant to another unit. Applicant further understands that roommate compatibility is NOT guaranteed.

Applicant represents that all of the above information is true and complete and authorizes the verification of same by reasonable means. Any misrepresentation or omission may be cause for the rejection of this application and/or the termination of the License Agreement. Applicant further authorizes free exchange of information between Salisbury and COCM, including but not limited to the applicant's student status, academic records, judicial records, and financial records.

Applicant understands that a financially-responsible Guarantor (at least 24 years of age) is mandatory for the completion of the Lease Agreement process, and failure or refusal to provide a Guarantor may result in the cancellation of this application and any resultant License Agreement.

Please be advised that incomplete, inaccurate or falsified information will be grounds for dismissal. Any individual, who may constitute a direct threat to the health and safety of an individual, the community, or the property of others, will be denied.

I AGREE: I, the Undersigned Applicant, have read and agree to all terms and conditions set forth in this application. I understand that this application is part of my license agreement, especially those areas regarding earnest monies.

The undersigned hereby offers to license a bedroom in a unit at University Park under the terms and conditions described herein. The undersigned understands that apartment availability is not guaranteed and that by submitting this application as interest in a bedroom in a unit at University Park, the undersigned is not guaranteed a license agreement. The undersigned understands that should a license agreement be sent, he/she must complete all License Agreement paperwork and pay all fees due to secure use of a bedroom within an apartment. The undersigned warrants that the above stated information - including but not limited to criminal information- is true and correct. Application and service fees are non-refundable.

APPLICANT SIGNATURE: