International Student Housing Application

When will you need housing at Allen?

Gender: Male Female

Legal Name: Email Address:

Date of Birth: 00/00/0000

Non-US Address: Number and Street City

District: Country Code:

Country:

Name of Legal Parent or Legal Guardian:

Non-US Address: Number and Street: City:
(if different than yours)

District: Country Code:

Country:

In Case of an emergency contact: Name: Phone Number:

Applicant Signature Date:

3. Pay the $125.00 housing deposit. Make your check or money order payable to ACCC or pay with Visa or Mastercard by phone--call Roberta Nickell at 620-365-5116 ext. 214.

4. A formal housing contract will be sent to you after payment of the housing deposit. Return signed contract as soon as possible to guarantee a room assignment.

**If you have been awarded an athletic scholarship, indicate which sport .