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Housing Application Form

Don't Just Attend CSUDH. Experience It

Discover the advantages that come with living on campus. Apply for housing today by following these simple steps.

STEP 1: Be sure to enroll at CSUDH before submitting this application. You must be enrolled to be eligible for CSUDH housing.

STEP 2: Print a copy of this application and mail it to the following address along with a non-refundable $30 Application Fee. Please make your check/money order payable to CSUDH Housing and send to CSUDH University Housing, P.O. Box 6228, Carson, CA 90746-6228

Student Information

Semester you are applying for: SummerFallSpring

Year:

First Name:

Last Name:

MI:

SSN / Student ID (leave blank if not known):

Birthdate (MM/DD/YY):

Gender: FemaleMale

Enrollment Status:

Are you applying to CSUDH through the International Student Services (ISS) Office? Yes No

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 (please note that double refers to two persons per bedroom, single to one person per bedroom: 1-Bedroom Double2-Bedroom Double3-Bedroom Double3-Bedroom Single

Roommate Request:

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

Are you disabled? Yes No

If yes, please comment on your disability: