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New Undergraduates UC-Charleston Housing Application

Before filling out this form:

Items in bold are required. 

For which semester are you applying for housing?   
First Name   
Middle Name  

Last Name 

Home Street Address (line 1)   
Home Street Address (line 2)  
State or Province   
ZIP or Postal Code   
Home Phone   
Cell Phone  
UC E-mail Address  
Alternate E-mail Address   
Date of Birth   [None] Select a Date Delete the Date  (Select the Birth Year FIRST from the calendar!)

The following Immunization requirements are consistent with West Virginia State Law and with the recommendations of the American College Health Association and the Advisory Committee on Immunization Practices.  Read more about our Immunization Policy.  Download the Immunization form.

Documentation MUST BE SUBMITTED prior to housing assignments being completed.

  For the following 3 items, please indicate if you have had your Immunization vaccinations. 
MMR (measles, mumps and rubella)
Hepatitis B    
Meningococcal meningitis    
 University Credit Hours Completed
(after current semester)
Athletic Teams  

Meal Plan Option 

First-year students may only select 1,2, or 3.

Upperclassmen may select 1,2,3, or 4.

Only apartment dwellers may select from all 6.






Rank your preference for room type. Use a 1 for first choice, 2 for second, and 3 for third. First-year students are limited to the first two choices. Transfer students can choose from any of the four choices listed. Assignments are completed on an availability basis.

Brotherton Hall Double


Brotherton Hall Single


Middle Hall Double


Ratrie Hall Double


Roommate Name


Roommate Preference 

I'd prefer a roommate who is (select one or more):
I'd prefer a roommate who likes (select one or more):
My music preferences (select one or more):

Do you plan to register an automobile on campus? 


I need American Disabilities Act (ADA) accommodations. 



APARTMENT AND SUITE INFORMATION: Only groups of four upperclassmen may apply for an apartment or suite. Each member of the group must have at least a 2.85 GPA for the group to eligible. Apartment and suite assignments will be determined by a formula that considers academic class, GPA, judicial standing, and community involvement. Please list one roommate under “Roommate Name” with whom you would like to live in the event that you do not receive an apartment or suite. 

Apartment/Suite Roommates


I am a member of (team, organization, group)


Number of occasions in violation of UC Student Expectations


Cumulative GPA 


All residential students are required to have health insurance while residing on campus. If you are in need of health insurance, please contact the Office of Student Life for information on available plans.

Emergency Contact 


Emergency Contact Relationship 


Emergency Contact's Primary Phone Number 


Emergency Contact's Secondary Phone Number


Health Insurance Company name 


Policy Number 


Group Number 


Health Insurance Company Phone Number 


Primary Care Physician Name 


Primary Care Physician Phone 


List any medical conditions, allergies, and/or medications that the University should be aware of in case of emergency (if none exist, type none) 

Medical Conditions  (if none exist, type none) 

I agree that checking this box and completing a housing application constitutes an agreement to comply with the terms and conditions of the Housing Contract and the policies and procedures of the University of Charleston. If under the age of 18, a parent or guardian is required to review the Housing Contract and to check this box, constituting an agreement to comply with the terms and conditions found herein.   

After clicking "Submit," if you are not taken to a page indicating your application has been received within 10 seconds, then you have not filled in all required fields. Please check your entries and then submit.