Housing Application - Barton College

Roommate Request - Roommate requests will be honored once your deposit and housing application have been
received (Prior to May 1). Please note that the person you request as your roommate must also note your name on his/her
housing application.
Roommate Information:
I have no specific request.
I would like to room with __________________________________________________________
Meal Plan Options (Required of all resident students)
14 Meals 19 Meals 10 Meals (only available to residents of East Campus Suites)
All resident students pay the same meal plan rate per semester. The difference between plans is placed in “Bully Bucks,”
which may be used to purchase additional meals in the Hamlin Dining Hall or purchases in Bully’s Campus Grill.
Meal Plan rates may change for the coming year.
Chronic Ailment/Disability for Placement Consideration
A copy of your medical documentation must be on file with the Director of Student Health Services for physical
disabilities and/or illnesses, and a copy of your medical documentation must be on file with the Director of Counseling
for any emotional or learning disabilities.
Housing Disability Assignment Process
A student with a documented disability may make a written request for reasonable housing accommodations or a
housing exemption. Said request should include an updated doctor’s notice of the student’s disability to determine
proper housing placement.
I agree to the terms and conditions of occupancy as stated
in the housing application.
________________________________________________________________
Signature
_____________________________________
Date
________________________________________________________________
Signature of Parent (If student is under 18 years of age.)
_____________________________________
Date
Off-Campus Housing
Please review the Residency Policy to determine
if you are eligible to live off campus. If you are
eligible, contact the Office of Residence Life
(252) 399-6386 or toll free, 1-800-434-4781, to
request an Off-Campus Housing Release Form.
(All request forms must be turned in by June 15th for fall
semester and December 15th for spring semester.)
OFFICE USE ONLY:
Residence Hall Assigned ______________________________________________________________________
Room Assigned ________________________________
P.O. Box Assigned ______________________________
Phone Extension ______________________________
Billing Status
Double Room Private Room
Date Deposited ____________________________
Meal Plan Option
14 Meals
19 Meals
10 Meals
P.O. Box 5616 • Wilson, NC 27893-7000
(252) 399-6386 • 1 (800) 434-4781
Fax (252) 399-6687
Assigned Roommate __________________________________________________________________________