Housing Application Form

Don't Just Attend CSUDH. Experience It

Discover the advantages that come with living on campus. Apply online here for housing today. Note: Paper applications are no longer accepted.

Student Information

Semester you are applying for:

Enrollment Status:

First Name:*

Last Name:*

MI:

Student ID:*

Birthdate (MM/DD/YY):

Gender: FemaleMale

Class Standing: FRSOJRSRGRESL/ALCP Student

Are you an international student studying on a student visa? Yes No

* Required field. For the Student ID, enter the number as it appears on your application acknowledgement letter or Student ID card. Current students: note that this application requires your new ID number and not those starting with "98".

Contact Information

Address:

City:

State:

Zip:

Country (if not USA):

Telephone (include Area Code):*

Fax (include Area Code):

E-mail Address:*

Preferences

Apartment Type Request (Double - two persons per bedroom. Single - one person per bedroom): 1-Bedroom Double2-Bedroom Double3-Bedroom Double3-Bedroom Single

Name of Requested Roommate(s):

Are you a smoker? Yes No (NOTE: All units in University Housing Services are NON-SMOKING.)

Do you have a disability? Yes No

If yes, please comment on your disability: