UNIVERSITY OF TECHNOLOGY, JAMAICA

STUDENT SERVICES DEPARTMENT

ACCOMMODATION OFFICE

Email address: boarding4@utech.edu.jm

Telephone: 970-5262/5191/5841, Fax: 977–3305

HALLS OF RESIDENCE APPLICATION FORM

FOR OFFICIAL USE ONLY
Accept: Reject: Waiting List:

Complete ALL sections applicable to you. Incomplete application forms will NOT be processed. ALL RETURNING RESIDENT AND NON-RESIDENT STUDENTS ARE REQUIRED TO SUBMIT A COPY OF THEIR PROGRESS REPORT TO THE ACCOMMODATION OFFICE FOR FINAL ACCEPTANCE.

SECTION A:To be completed by all applicants		UTech ID
Application Type: (Please select where applicable)

New Student	Returning Resident Student	Returning Non-Resident Student
Community College Transfer	Inter Department/Faculty Transfer Student

Title	Surname	First Name	Middle Initial	Gender	Date of Birth
PERSONAL INFORMATION

CONTACT INFORMATION
Cell Number		Home Number	Work Number
Office Number	Email Address

ADDRESS DETAILS
Nationality
Address Type	P.O. Box	Street	Town	Parish	Country
Present Address
Mailing Address (If different from personal)

EMERGENCY CONTACT
Name:			Relationship:
Address:			Tele:

MEDICAL INFORMATION
Name of Family Physician:	Contact:
Do you have any specific medical problems?		Yes No
If yes please specify:
Special Needs:		Yes No
Please explain

ACADEMIC INFORMATION
What faculty did you apply to or was accepted for at UTech?
Which programme did you apply to or was accepted for at UTech?
Year of Study

SECTION C: To be completed by all applicants (Except Returning Resident Students)

Please list extra-curricular activities you have been involved in at high school, community college, university and in your community over the last two years
1.			3.
2.			4.
Please list your special skills, experience and abilities
1.			3.
2.			4.
Please list some attributes that best describe you
1.			3.
2.			4.
In not more than five (5) sentences, outline your reasons for boarding on campus apart from location and cost.

SECTION D: To be completed by Returning Resident students only

Hall/Block	Years on Dorm	Room Number
List Hall Committee(s) on which you have served:
1.	2.	3.
Hall or University Events/activities participated in:
In the space below, write a short paragraph outlining why you should be readmitted to the Hall.

I hereby certify that the information given above is true and declare that I will comply with the rules and regulations listed in both the general Student and Resident Student Handbooks.

Signature

Date

NOTES

Acceptance to the University does not guarantee on-campus accommodation.
Only full time students are eligible to apply for on-campus accommodation.
It is your responsibility to update your contact information after completing an application form.
Persons who have been offered and accepted a place on the Halls of Residence will only be guaranteed accommodation for a period of one academic year, providing that all rules and regulations are adhered to.
Students, who have been assigned on-campus accommodation, please note that fees are payable at any branch of NCB, Paymaster, Bill Express and UTech Accounts Receivable using a debit card or manager’s cheque.
Students who have been accepted to the University, and requested accommodation MUST contact the Accommodation Office to verify their status.
PLEASE CONTACT THE ACCOMMODATION OFFICE TO ENSURE YOUR APPLICATION WAS RECEIVED.