Student Housing Application

Applicant Legal Full Name(Required)

First Middle Last

Date(Required)

Preferred Name

Date of Birth(Required)

TRC Student ID Number(Required)

Gender (assigned at birth)(Required)

Male

Female

Preferred Pronouns

She/Her

He/Him

They/Them

Other

College Status(Required)

First Year

Second Year

Other

Semester you are applying for(Required)

Fall

Spring

Year you are applying for(Required)

Permanent Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primay Phone

Cell Phone(Required)

Email Address(Required)

Parant/Guardian Full Name(Required)

First Last

Parent/Guardian Phone(Required)

Emergency Contact(Required)

First Last

Emergency Contact Phone(Required)

Note on Lease Length: Rivers ridge Apartments offers lease in semester/term increments. Leases will be renewed the beginning of each semester/term. Apartments may be occupied during academic breaks within lease term.

Special needs to be considered(Required)

Would you like to receive information about being a Resident Assistant at Three Rivers College?(Required)

Yes

*You are not obligated to apply or complete an interview. If you mark “yes” you will receive an email in the semester prior to your start date with more information on becoming a Resident Assistant.

Now that you have completed your Housing application, please make a payment of $200 through the Student Accounts Office. The office accepts payments in person during business hours, by mail at Three Rivers College, ATTN: Student Accounts Office, 2080 Three Rivers Blvd., Poplar Bluff, MO 63901, and by phone at 573-840-9662.*

*Scholarships, grants, and loans cannot cover this cost. It must be paid at the time the application is submitted. Your accomodation is only reserved when all paperwork and payments have been submitted and cleared.

Refud Policy: After you have submitted this application and payment, you may cancel this agreement. Upon cancelation, you will receive $150 of your security deposit back. The remaining $50 is retained by the institution for application processing fees. This notification must come via your student email, or submitted via signed notification.

For Your Room Assignement

Sleep pattern(Required)

Morning Person

Night Person

Other

Eating Habits(Required)

Eat in/cook

Eat out

Other

Study Habits(Required)

Music Preference(Required)

Hobbies(Required)

What kind of suitemate would you prefer?(Required)

Is there anyone you would like as a suitemate?

*While accommodations can be requested; they are not guaranteed

I hereby understand that I am applying to live in the Rivers Ridge apartments on the campus of Three Rivers College and recognize this form is not a lease. I have fully and wholly read and understand the application. I attest that all the information contained herein is correct. Should any of this information be found inaccurate, misleading, or false, it may lead to immediate eviction from Rivers Ridge Apartments. Permission is granted to use photos for College purposes.

Applicant Signature(Required)

Date(Required)

Three Rivers College is an equal opportunity institution that commits itself to the policy that there will be no unlawful discrimination against any person because of race, color, gender, sexual orientation, religion, age, disability, or national origin.

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For Office Use Only

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Application Received

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Deposit Paid

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Room Assignment

This field is for validation purposes and should be left unchanged.

College Closed for Christmas Break