Housing Application

Housing applications are considered ONLY after a student has been accepted into a Southeast Tech program. If you have questions about that process, contact your Admissions Representative. Incomplete applications may not be considered for Housing.

Are you an accepted student at Southeast Tech?: *

Last Name: *
First Name: *
Middle Name:
Email: *
Street Address: *
City: *
State: *
Zip Code: *
Southeast Tech Student ID Number: *
Home Phone:
Cell Phone: *
Birth Date (MM/DD/YYYY): *
Gender: *
Field of Study: *
Please select the Academic Term that you wish to begin living in Housing: *
Roommate Preferance (if any)
Full Name of Roommate Preference #1:
Full Name of Roommate Preference #2:
Full Name of Roommate Preference #3:
Hall Preference: *
Emergency Contact Information
Please provide the following information to be used in the case of an emergency situation (i.e. parent/guardian)
Last Name: *
First Name: *
Relation to Student: *
Home Phone:
Work Phone:
Cell Phone: *
Special Accommodations/Other Information
Do you require special accommodations for Housing placement?*: *
If yes, please explain:
*All accommodation requests based on medical/special circumstances require official documentation from required personnel to be filed with Southeast Tech.
Are you currently, or have you ever been, required to register as a sex offender?**: *
Are you currently under investigation, been convicted, pled guilty, entered a no contest plea, or received a suspended imposition of sentence of a felony?**: *
**If you answered "Yes" to either of the questions above, please provide a detailed explanation: