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Hall Application Form PDF

The document is a hall of residence application form for students applying to live in on-campus housing at the University of the West Indies Mona campus for the 2010-2011 academic year. It requests personal information such as name, address, emergency contact, and medical conditions. It also asks for academic details like intended faculty, program of study. Applicants select their preferred residence hall and must agree to the university's conduct policies to be eligible for on-campus housing. If accepted, housing is guaranteed for one academic year only.

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Sash1693
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Download as PDF, TXT or read online on Scribd
145 views

Hall Application Form PDF

The document is a hall of residence application form for students applying to live in on-campus housing at the University of the West Indies Mona campus for the 2010-2011 academic year. It requests personal information such as name, address, emergency contact, and medical conditions. It also asks for academic details like intended faculty, program of study. Applicants select their preferred residence hall and must agree to the university's conduct policies to be eligible for on-campus housing. If accepted, housing is guaranteed for one academic year only.

Uploaded by

Sash1693
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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THE UNIVERSITY OF THE WEST INDIES

MONA CAMPUS

OFFICE OF THE CAMPUS REGISTRAR


HALL OF RESIDENCE APPLICATION FORM
ACADEMIC YEAR 2010/2011
New Students (Full Time only)
Kindly fill in the form using BLOCK letters.
Completed forms MUST be sent directly to the desired Hall of Residence.

Personal Information
Please affix
photograph here

UWI ID/ Registration No.

____________________________________

SURNAME:

____________________________________

FIRST NAME :

____________________________________

HOME ADRESS:

______________________________________________________

(Including Country)

______________________________________________________________________________
Mailing Address (if different from above:
______________________________________________________________________________
GENDER:

Female/ Male

DATE OF BIRTH: __________________________


dd/mm/yy

TELEPHONE:
E-MAIL:

_______________________

________________________

(Home)

(Mobile)

__________________________________________________________________

Person to be contacted in case of an emergency:


NAME :

_____________________________________________________________________

RELATIONSHIP TO APPLICANT: _______________________________________________


ADDRESS: ___________________________________________________________________
TELEPHONE :

______________
(Home)

_____________
(Mobile)

_______________________
(E-Mail)

Do you have any known medical condition or physical disability? ________________________


If yes, please state: _____________________________________________________________
Family Physician: _______________________________________________________________
Contact:

_____________________________________________________________________

High Schools/Tertiary Institution attended: __________________________________________


______________________________________________________________________________

Co Curricular Activities:

______________________________________________________

______________________________________________________________________________
______________________________________________________________________________

Academic Information
Postgraduate
FACULTY

Undergraduate
______________________________________

PROGRAMME/COURSE OF STUDY ____________________________________

Hall Information (Please tick the appropriate choices)


NAME HALL

TYPE

Mary Seacole Hall


UWI Mona, Kingston 7
[email protected]
Tel: 1-876-935-8483
Chancellor Hall
UWI Mona, Kingston 7
[email protected]
Tel: 1-876-927-2780
Fax: 1-876-970-3554
A.Z. Preston Hall
UWI Mona, Kingston 7
[email protected]
Tel: 1-876-977-6721-3
Fax: 1-876-927-1600
Irvine Hall
UWI Mona, Kingston 7
[email protected]
Tel: 1-876-927-2793-4
Fax: 1-876-927-2754
Taylor Hall
UWI Mona, Kingston 7
[email protected]
Tel: 1-876-927-2533
Fax: 1-876-927-2533
Rex Nettleford Hall
UWI Mona Kingston 7
[email protected]
Tel: 1-876-977-60833 / 1-876-977-0214
Fax: 1-876-977-5644
Western Jamaica Campus Hall
[email protected]
Tel: 1-876-940-4349
Fax: 1-876-971-1283

Female Only

Male Only

Male and Female

Male and Female

Male and Female

Male and Female

Male and Female

Have you ever lived in a hall of residence/dormitory before?


Was it a hall of residence at UWI, Mona?
If Yes state which one:

Yes

Yes

No
No

__________________________________________________________

State the period for which you previously stayed in hall (if applicable): ___________________________
*Students who have been accepted to the University, and who requested Hall Accommodation must
contact the Hall to which they applied to verify their accommodation status. Students must notify
the Hall immediately if accommodation is no longer required. Please be advised that only full time
students are eligible to apply for room in a Hall of Residence.
I UNDERSTAND AND AGREE THAT:
(1) Acceptance to the University does not guarantee an assignment to a room.
(2) The Universitys regulation on conduct and policies under which housing facilities are
operated must be observed at all times during the period of residence.
(3) It is my responsibility to update my contact information.
(4) If I fail to respond to ANY correspondence from the Halls of Residence by the stated
deadline my application will be cancelled.
(5) Persons who have been offered and accepted a place in a hall will only be guaranteed
accommodation for a period of one academic year, providing that all terms and conditions
of the Hall Agreement and Tenancy are adhered to.
Date: _________________

Signature:

________________________ _______

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