Residence Hall Application & Contract 2016-2017

Student Information:

* To receive Residence Life newsletter.

Emergency Contact:

(Same as Permanent Address )

Missing Person Contact Information:

(Same as Emergency Contact )

Academic Information:

Academic Major:
Semester you are applying to enter housing:

Lifestyle Preference:


Housing Options:

Note: If your request is a medical accommodation, the University of Detroit Mercy is deeply committed to the full participation of students with disabilities in all aspects of college life. In accordance with Section 504 of the Rehabilitation Act and the American Disabilities Act, please click here for more information.

Additional Information:

Residence Hall and Room Preference:

All First-Year freshman under 19 years of age are required to reside in Shiple Hall with the First Year Experience. College credit accrued in High School is not applicable.

Residence Hall Preference: Please rank the following (1-6)
Suite Style Hall (Upperclass/Graduate students only):  
Room Type Preference:

Meal Plan Options:

Choose any option below. All residents must choose a meal plan unless living in West Quad. Meal plan changes must be made with the Office of Residence Life before the end of the second week of the semester. Freshman students can only choose from Block 190 or Block 255 options:

I acknowledge and agree to the terms and conditions in this contract. I agree to abide by the terms of this Contract and agree that all information submitted on the form is accurate. Falsification of any information may result in revocation of this Contract and/or disciplinary action. Note: The Office of Residence Life will make every effort to accommodate your requests. However, we cannot agree that all requests can be fulfilled. If there are any changes to your application, it is your responsibility to contact the Office of Residence Life with corrections to your contract, emergency contact information, or missing person contact information.

Please type your full name, acknowledging that you understand the terms and conditions of this contract: