Name_____________________________ Birthdate__________________
SSN_________________
Address _________________________________________________________________________
Street City State Zip
Phone _____________________________ Email
_____________________________________
Check-in Date _____________________ Check-out
Date _____________________
Your employer (in DC) __________________________ Phone______________________
Emergency Contact Person ______________________ Phone______________________
Address ________________________________________________________________________
Street City State Zip
I
understand rent is payable, upon check-in, and the first of each
month thereafter. I am required to give at least one week's notice
before vacating my room or I will be responsible for paying rent
for that period. I agree to abide by all rules and regulations
of Thompson-Markward Hall.
Signed _____________________________________________ Date___________________ |