Affinity Housing Application

** PLEASE DO NOT USE ANY SPECIAL CHARACTERS (QUOTATION MARKS INCLUDED) IN ANY OF YOUR ESSAY QUESTIONS. THIS WILL CAUSE ERRORS TO THE FORM AND IT WILL NOT SUBMIT PROPERLY. **

Applications should be submitted by midnight on the affinity application deadline for the term for which you are applying, outlined below:

Term	Deadline
Summer 2012	April 6, 2012
Fall 2012	April 6, 2012
Winter 2013	October 5, 2012
Spring 2013	February 1, 2013

Any applications submitted after that time will be considered late, and will only be reviewed after all on time applications have been reviewed.

If you are applying for housing for Winter, Spring, or Summer Term you must also complete the standard Housing Application (available on BannerStudent) by the application deadline for the term for which you are applying. Students applying for Fall Term housing do not need to complete the application on Banner Student.

Any student, including leave-term students, living in an affinity program must participate in a College dining plan at a level no lower than the "SmartChoice 5" (or its equivalent).

Personal Information

Last Name

First Name

Middle

E-Mail address

Campus Phone

Home Phone

Hinman Box

DID	Class	Major
Gender	Nationality

D-Plan

Have you ever lived in an Affinity House before?

If so, please list which house(s) and term(s):

I am interested in applying to the following Affinity Programs:

Please list which term(s) you are applying for:

Terms Applying For
Summer (X12)
Fall (F12)
Winter (W13)
Spring (S13)

Please list in order your preference for housing, from most- to least-preferred (e.g., Shabazz, LALACS, etc.):

Housing for Medical/Disability Needs

Dartmouth College is committed to ensuring our residential programs are readily accessible to and usable by students with disabilities as reflected in its Undergraduate Housing Relocation Policy for Students with Disabilities. If you have questions about the accessibility of any of our Affinity Programs, please contact the Undergraduate Housing Office at 603-646-3089 or keys1@dartmouth.edu.

Do you require Housing for Medical/Disability Needs? (Click one) Y N

If Yes, please fill out and submit the following forms to the Housing Office:

Housing Information and Medical Care Provider Form (opens in new window)
Housing for Medical/Disability Needs Application (opens in new window)

If you are unable to access any of these documents, please contact the Housing Office at 603-646-3093 or keys1@Dartmouth.EDU.

Submitting the Application

When you press the button below, a series of popup windows will appear, one for each Affinity House you have checked. In each window will be questions which you will be required to answer.

The button will be enabled when you have provided all required information and have checked at least one Affinity House above.

When you have answered all the questions, you can submit your application form.

After hitting the "Submit Application" button, you will receive a confirmation email with your application information.

If you do not receive a confirmation email, we have not received your application. Please email the Housing Office immediately at keys1@Dartmouth.EDU so we can work with you to get your application submitted.

Last Updated: 5/9/12

Chinese Language House International Program Shabazz Center for Intellectual Inquiry Foley Cooperative Inter-faith Living and Learning Community	LALACS Home La Casa Native American House Hillel Apartments MAHA Arabic Language Community	French/Italian Program Kade German Center Sustainable Living Center
If you have any questions, please email the program you wish to apply to directly.
Note: the Chinese Language House, La Casa, LALACS, and the Native American House are substance free buildings.