Name: 

Identification Number:          

Cell Number:          

Email Address:          

Assignment

Hall:           Collegiate Park Northpark Building 1   

Room:               

Assignment Date:     

Summer Session:           Summer 1 Summer 2 Both Summer Sessions

Meal Plan:           No Meal Plan 250 Flex pts 300 Flex pts 350 Flex pts

I accept do not accept - the terms of this contract.

Digital Signature (Last 4 digits of SSN):          

Parents Digital Signature if under 18: