Lehman College Housing Application

Student Information

First Name

Last Name

Student ID (8-digit CUNYfirst ID / EMPLID if known)

Date of Birth

Gender

Preferred Email Address

Mobile Phone

Billing/Mailing Address:

Country

Street

City

Region

Postal Code

Parent/Guardian Contact information:

Name

Relationship

Phone Number

Enrollment Information

What college do you attend?

Other College You Attend

Type of student

Anticipated Enrollment Status

Full Time

Part Time

What is your Major?

Expected Graduation Term

Accessibility/Emergency Information

Do you require housing accommodations due to a disability?

Yes

If yes, student will be contacted by Student Disability Services to engage in the interactive process.

Emergency Contact Information:

Name

Relationship

Phone Number

Please acknowledge the following:

I understand that financial aid may not fully cover housing costs

Yes

I understand that I am responsible for any outstanding balance

Yes

I understand that housing charges will be billed through my student account

Yes