Student Information

Last Name *

Middle Initial

First Name *

Street Address *

City *

State *

Zip *

Primary Phone *

Alternate Phone *

Email Address 1 *

Email Address 2

Gender *

Date of Birth * +

The semester for which I am applying will be my *

Occupancy to begin *

Year *

Program of enrollment at Ranken *

Do you intend to apply financial aid toward the cost of housing, if it is an option? *

Yes

No

Are you a citizen of the United States? *

Yes

No

If not, are you authorized to live in the United States?

Yes

No

Have you ever been convicted of a felony or a misdemeanor? *

Yes

No

If yes, please explain: *

Applicants who have been convicted of or plead guilty to a misdemeanor or felony may be required to go through an interview process as part of the admittance process into the residence hall. The Director of Residential Life will make all final decisions regarding admission to the residence hall and may impose conditions on the student’s admission to the residence hall. Failure to list felony or misdemeanor convictions on the application will result in non-acceptance or dismissal from Ranken housing.

Emergency Contact Information

First Name of parent or guardian *

Last Name of parent or guardian *

Address of parent or guardian

City of parent or guardian

State of parent or guardian

Zip of parent or guardian

Phone of parent or guardian

Alternate Phone of parent or guardian

Email Address

Health Insurance Information

All residents are required to have Health Insurance during residency.” Residential Life will send information on available resources if you’re not covered

Do you currently have health insurance, or are you covered by a parent's/guardians plan?

Yes

No

If "yes", name of your insurance company

Name of primary policy holder

Policy number

Room Preference

The room preference section of this application is only in place to give the Residential Life Office an idea of a student’s room preference. There is no guarantee that room preferences will be honored. Factors including the order in which a completed application, contract and security deposit have been received by the Residential Life Office, the student’s housing history (first time resident or returning resident), the student’s finances being in order and available space will all be considered when making room assignments. Students who submit their materials early will have a greater chance of having their room preference honored. Walker Hall has ADA handicap accessible rooms. Students have the obligation of notifying the Residential Life Office regarding the nature of their disability and need for accommodation. Documented proof of a disability may be requested in some cases. If you have a disability and require a handicap accessible room, please select Type A.

Room Preference

Type A: Single unit w/ Private bathroom ($2,875 per semester)

Type B: Single unit w/ Shared bathroom ($2,875 per semester)

Type C: Double Unit with 1 bathroom ($1850.00 per semester and $925.00 per semester for 8 week Internship Residents)

Type D: Shared Apartment w/ 1 bathroom, living room and kitchen equipped with refrigerator, microwave and stove ($2,875 per semester)

Type E: 4-Bedroom Apartment w/ 2 bathrooms, living room, and kitchen equipped with refrigerator, microwave and stove ($2,875 per semester)

Please explain your disability and your accommodation requests in the space provided

Meal Plan Preference

Please select your meal plan option from the list below. All day school students living on campus are required to purchase a meal plan. The meal plan is a declining-balance system, meaning the cost of each meal purchased is deducted from your meal plan balance. Click here for more information on our current meal plans, and the average cost of food from our dining hall. Information will open in a new window.

Meal Plan Preference

$1,000 per semester plan

$1,200 per semester plan

$1,400 per semester plan

$600 per semester (ONLY Mid-Year and Summer)

Laundry Plan

The cost for the laundry plan is $75 during the school year and $30 for the summer semester, which provides unlimited access to the laundry room. The cost is deducted from your meal plan. Would you like to register for this access?

Laundry Plan

Yes

No

Personal Profile

Please complete the personal data section completely and honestly. Your responses will assist the Residential Life Office in determining a roommate or roommates that you may be most compatible with.

Listing a preferred roommate or roommates does not ensure that you will room with that person or persons. If you list the person or persons you would like to room with, and they list you on their application or applications, then chances are greater that you will get your preference. If you write in a preferred roommate and that person does not list you as a preference then your request will not be granted.

Do you have a specific person or persons you would like to have as a roommate?

Yes

No

If yes, please list the person or persons here

Would you mind having a roommate who has visitors on a regular basis? *

Yes

No

Would you prefer to room with someone that is in your major program? *

Yes

No

Do you smoke? *

Yes

No

Would you mind having a roommate who smokes? *

Yes

No

Do you prefer to live with someone that gets up early in the morning? *

Yes

No

Do you go to bed late most nights (after 11 p.m.)? *

Yes

No

Do you prefer to live with someone that stays up late? *

Yes

No

Do you require complete silence when you are sleeping? *

Yes

No

Do you mind low-level noise while you are sleeping? *

Yes

No

What types of music do you listen to? (Check your top three) *

How to you prefer to study? *

Alone

With others

When I study, I: *

Am able to tune out most noises and am not easily distracted.

Like low-level background noise or music.

Require absolute quiet.

I am most comfortable in my room when: *

It is neat and everything is where it belongs

It is clean, but it can be cluttered.

It doesn't matter how it looks as long as it is clean.

How comfortable are you with sharing your possessions? (Computer, CD’s, DVD’s, etc.) *

I am comfortable with letting others use or borrow my things.

I have to trust the person before I let them borrow or use my things.

I am uncomfortable allowing others to use or borrow my things.

Which of the following best describes your personality? *

Outgoing and social

Quiet and reserved

What are your main hobbies and interests? *

What clubs do you belong to or plan on joining at Ranken?

Are there any other special considerations you would like to mention?

Application, Contract and Security Deposit

In order to be approved for housing, applicants must submit a housing application, signed housing contract and a security deposit. In addition, applicants must be approved by the Residential Life office as well as the Business and Financial Aid offices.

Background Check Release

By submitting this form I authorize the Residential Life office at Ranken Technical College to conduct a background check on my behalf. I also authorize the release of my academic and behavioral records on file at Ranken Technical College to the Director of Residential Life for examination. I understand that the initial approval process for housing is pending based on inspection of the background check and academic and behavioral records. I understand that the purpose of these procedures is to ensure the safety and well-being of all dormitory residents and Ranken employees who will be working in the dormitory. I hereby release the College, its employees and officials from any liability for the release of information requested above. I understand that failure to sign this release will result in non-acceptance to Ranken housing.

Please use your mouse or you finger if using a touch screen to sign your name (or if student is under 18, name of parent or guardian). *

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