Freshmen will be given first preference; however, NO housing will be guaranteed. TRANSFER # OF CREDITS. Yes No WAKE- UP TIME. 10am- 6am-8am 8am-10am

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NAME: ADDRESS: LAST FIRST M.I GENDER D.O.B. STUDENT ID NUMBER STREET CITY STATE ZIP HOME TELEPHONE CELLULAR TELEPHONE EMAIL ADDRESS Freshmen will be given first preference; however, NO housing will be guaranteed. STUDENT TYPE (Check One): 1 st Time FRESHMAN TRANSFER # OF CREDITS 1 ST Time GRADUATE CONTINUING Student RE-ADMIT Student OCCUPANCY DESIRED (Check One): SINGLE* DOUBLE SINGLE IN SUITE* DOUBLE IN SUITE* HALL TYPE DESIRED (CHECK ONE): Same Gender Co-Ed Yes No WAKE- UP TIME 10am- 6am-8am 8am-10am 12pm SMOKER STUDY PREFERENCE Day Night Noisy Quiet No Preference * Singles are limited and are assigned on a first come first serve basis. * Single in suites and double in suites are reserved for upper-class students only.. Do you have a medical condition that should be considered in making a room assignment? If so, please explain. Please contact the Department of Residence Life and the Students with Disabilities Program (804-524- 5061) no later than May 1 st for the Fall semester and November 1 st for the Spring semester to discuss specific accommodation requirements. Meal Plan Options (Freshmen are automatically assigned the 19 meals meal plan; Graduate & Transfer students with 30+ VSU accepted credit hours can choose either option. All meal plan options are the same price, $2,069.) 19 Meals / $0.00 Dining Dollars 14 Meals / $150.00 Dining Dollars 10 Meals / $250.00 Dining Dollars

AGREEMENT REQUIREMENTS 1. Admission to Virginia State University. 2. Full-time student, or in final semester prior to graduation 3. Clearance of any outstanding balances with student accounts 4. Paid required fees for housing, prior to the Deadline It is strongly suggested that payments be submitted no less than one week prior to the deadline to allow time for processing. TERMS AND CONDITIONS 1. PERIOD OF AGREEMENT: This Agreement is for the Fall and Spring semesters of the academic year. The student signing this Agreement will live in University housing with an on-campus meal plan for the entire period of the Agreement. The Agreement period begins the first scheduled date of the arrival of residential students for the Fall semester and ends on the last day of final examinations for the Spring semester. A student who enrolls late and applies for residence hall accommodations will be bound by this Agreement for the balance of the period. 2. REQUIRED FEES: NEW HOUSING RESIDENT: Housing Deadline (Fall - May 1, 2014) / (Spring - Nov. 1, 2014) $150.00 Non-Refundable Reservation Fee $150.00 Refundable Room Damage Deposit RETURNING RESIDENT: Fall Housing Deadline (March 23, 2014) $150.00 Non-Refundable Room Reservation Fee 3. PAYMENTS: The resident agrees to retain accommodations for the entire period and to render payment to the University at the established rate for both room and board. Room and board rates are payable by the semester. All payments must be made prior to, or not later than, the time of validation. Failure to comply will result in the loss of the student s room assignment. Checks or Money Orders must include the student s Full Name (first, middle, and last), ID number (provided by Admissions), and Date of Birth. Each payment sent should clearly indicate the type of payment being made: Room Damage Deposit / Non Refundable Room Reservation Fee DIRECT ALL PAYMENTS TO THE UNIVERSITY CASHIER: In Person: Room 112 Virginia Hall By Mail: Virginia State University, Cashiers Office, and Campus Box 9125, Petersburg, VA 23806 By Phone: (804) 524-5150 (Debit/Credit Card payments) Page 2 of 8

4. HOUSING PROCESS: Students seeking housing must submit the required fees prior to their Housing Agreement being processed. If an Agreement is submitted prior to the payment, the student will be responsible for notifying the housing office by email, once all required fees are paid (ResLife@vsu.edu). Room assignments are made only after the receipt of a signed Housing and Food Service Agreement and all required fees have been paid. 5. ROOMMATE REQUESTS: First-time (freshmen) & transfer students cannot make roommate requests as they are randomly assigned. 6. SINGLE ROOM REQUESTS: Singles are extremely limited and are assigned first come first serve. Double rooms that are converted into singles rooms come with an additional fee of $530.00 per semester and are contingent upon housing capacity and availability. The fee must be paid prior to receiving the single room and only after approval by the Director of Residence Life. Monies applied for a single room, which was not occupied, will be credited to the student s university account. 7. ROOM ASSIGNMENTS: Students, who submit their Housing & Food Service Agreement and pay fees prior to the posted deadline, can expect to receive their housing assignment via their VSU email account. Students whose Housing & Food Service Agreement and fees are received after the deadline will be placed on a waiting list and will receive a room assignment according to the following: (1) the date that the signed housing Agreement was received; (2) the date all required fees were posted to their university account; AND (3) when space becomes available. 8. MOVE-IN DATES & DEADLINE: FALL SEMESTER SPRING SEMESTER New Student Move-in Date: Sat/Sun August 9/10, 2014 Saturday, January 10, 2015 Move in Deadline: Monday, August 11, 2014 Sunday, January 11, 2015 Continuing Student Move-in Date: Tuesday, August 12, 2014 Thursday, January 8, 2015 Move in Deadline: Wednesday, August 13, 2014 Friday, January 9, 2015 Early Arrivals Virginia State University does NOT accommodate early arrivals. Students seeking to enter VSU before the posted move-in date should make arrangements with local hotels/motels. Late Departures Residents seeking to remain on-campus beyond the stated Agreement period (i.e., term breaks and year closings) must submit the extended stay request form for approval to the Director of Residence Life within 2 weeks of the last day of regular classes prior to the subject break. Any resident approved by the Department of Residence Life to remain after the closing of Residence Halls will be assessed $40.00 per day, to be paid in advance to the Cashier s Office (this does NOT include meals). CLAIM IT OR LOSE IT: Failure to claim a room assignment by the designated move--in deadline will result in the student automatically forfeiting their room assignment, and possibly the right to a reassignment during that term. Page 3 of 8

ROOM CHANGES: Requests made for Room Changes will NOT be honored unless the request is made during the designated Room Change Period, which occurs at the conclusion of the late-registration/validation period of each semester. At the appropriate time, the Director of Residents Life will announce the Room Change Period. Students are responsible for knowing when the Room Change Period begins and ends. If a student wishes to change their assignment, they must obtain the Room Change Form and detailed instructions from their Residence Educator. If the request is feasible, the Housing Office will grant the student s request. The University does not provide moving assistance for students seeking a room change. If a student moves without authorization, they could lose their room assignment and will be charged up to $3,896.00 for an unauthorized move. The University reserves the right at any time to (a) assign temporary housing if demand exceeds capacity; (b) Alter or cancel an assignment; (c) require a student to move from one room and/or residence hall to another; or (d) consolidate vacant spaces / rooms to achieve maximum occupancy. Residents who fail to consolidate are subject to possible disciplinary action. If there is a conflict between residents that cannot be resolved amicably, the Director will move all parties involved. 10. FOOD SERVICE: All students living in University Housing must participate in the meal plan and will be automatically charged the approved meal plan rates. There will be no refunds for missed meals. Students with special dietary needs must contact the Office of Student Health Services. The meal plan begins with the first day of arrival of residential students in the Fall and extends through the last day of Spring semester final examinations. The dining hall will be closed between semesters and during scheduled holidays and breaks (Thanksgiving, Fall, Winter and Spring). Residence hall students are responsible for having their University One Card validated at the designated time and location for use in the dining hall and/or on-campus retail locations. Failure to do so does not relieve a student from paying meal charges. Virginia State University meal plans have been designed to accommodate the various needs of our students. The meal per week allowance come as part of all our meal plan options and allows you to enjoy the number of meals specified in the plan. You can use your meals for breakfast, lunch, and dinner in our all-you-care-to-eat dining halls and/or in our various five retail locations using meal equivalency options. Each time you use a meal, it is subtracted from your daily/weekly balance. First-year resident students are required to sign up for the 19 meal plan. Upper-class students (30 credit hours or more) have the option to purchase a 19, 14, or 10 meal plan. The 14 and 10 meal plans include dining flex dollars which may be used for additional meals or in the retail units. Upperclassmen must request the 14 or 10 meal plans as their dining option during the housing lottery period or the validation period as meal plan changes will not be granted after the closing of late validation period. Meal plan dining flex dollars do not carry over from one semester to the next, nor are there any refunds for unused meals or dining flex dollars at the end of the semester. When you become a meal plan member, your student ID card (One Card) becomes your pass to use your meal plan in Jones and/or Gateway Dining Halls and any of the five on-campus retail food service venues. Meals do not carry over from day to day, week to week, or semester to semester. Additionally, meal plans are reset every Sunday night. Additional information regarding Food Services should be obtained directly from Thompson Hospitality - (804) 524-5112. Page 4 of 8

11. FACILITY: Under the terms of this Agreement, Virginia State University agrees to provide furnished living spaces with cable and internet connections in the residence halls and to provide facility maintenance as required. The University Post Office will provide postal boxes for each residential student. Each hall is equipped with computer labs. There will be absolutely no TAMPERING with any computer equipment. All requests for room repairs must be reported to the Residence Hall staff immediately. Any damages caused by tampering with State property will result in full charge for repairs or replacement. 12. LIABILITY: Although the University will use reasonable efforts to protect student s property, the student agrees to accept full responsibility for loss or damage to personal property. The purchase or expansion of household content or renter s insurance is recommended to cover personal belongings prior to the resident s move-in at the University. The student agrees to cooperate with his/her roommate in the common protection of their property. Room doors are to be locked at all times. The student agrees that any personal effects, valuables or other property of the student left in the residence halls after expiration of the Agreement period, residence hall closures and openings and/or winter and summer breaks and not claimed within 10 days after the end of such period may be considered abandoned and will be retained by the University as its property. 13. RESIDENCE HALL MAINTAINANCE Residents are responsible for maintaining established standards of cleanliness and safety throughout the building. Specifically, residents are solely responsible for maintaining the cleanliness of their rooms and, where applicable, entire suites including living room areas and bathrooms. Residents are responsible for notifying the Residence Educator directly of any maintenance needs, or extermination issues that need to be addressed. 14. DAMAGES Common area repair cost as a result of willful abuse, vandalism and otherwise disorderly conduct will be prorated among residents, and each account will be billed accordingly. In the event of major damages to furniture or fixtures within a specific residence hall or to the physical facility, damage(s) will be evaluated and each resident will be assessed an equal amount based on the cost incurred to restore damaged furniture, fixtures, or physical facility to its original condition. The University reserves the right to apply all or a portion of a student s housing deposit toward payment of any room and board charges or other University charges at the time of departure from the residence hall. 15. SAFETY AND COMPLIANCE WITH FEDERAL AND STATE LAWS AND UNIVERSITY POLICY To protect the health, safety, and welfare of the University and its community, the University reserves the right for authorized representatives to enter residence hall rooms at any time for the purpose of inspection, repair, and/or maintenance and the establishment of order. You acknowledge that the use, distribution or possession of illegal drugs, and the use, distribution or possession of illegal contraband or stolen property, or unlawful possession or distribution of prescription drugs is against Virginia and/or federal law. You further acknowledge and agree that University staff, officials, or the campus police may cause you to be arrested and criminally charged for violation Page 5 of 8

of federal or state drug laws, or for theft or possession of stolen property. Possession or use of weapons is prohibited, even if the resident has an issued weapons permit. Pets of any kind are prohibited in residence halls. Maintenance and health and safety inspections are undertaken for health, sanitation and safety reasons. If, however, illegal substances or other evidence of policy violations are found in plain view during maintenance or housing inspections, or in response to an emergency involving student health or safety, residents of the area may be subject to police action (including arrest) and/or a referral to Judicial Affairs for violations of the University Student Code of Conduct. If necessary, VSU or Chesterfield County Police may conduct searches of residences for illegal drugs, contraband or other illegal activity by obtaining search warrants or gaining the resident s consent to search. The University reserves unto itself the absolute right to enter and inspect any room in order to maintain discipline or protect the property or the health and safety of its students. Inspections may occur as frequent as necessary when there is reason to believe that the occupants of the room are in serious physical, psychological, or emotional distress. Students are expected to maintain an acceptable level of cleanliness in their rooms for health and safety purposes and to reduce the likelihood of bug infestation. Thus, prior to moving into your assigned residence hall; all students should properly clean all clothing and inspect all personal items. Residents who fail to clean their rooms will be fined and/or subject to removal from the residence halls. The University strictly enforces Safety and Fire regulations. Persons who are identified removing, destroying, or otherwise tampering with safety equipment will be subject to disciplinary actions in addition to restitution for damages. Residency is subject to inspection visits by the Fire Marshall. Personal electrical equipment allowed in the residence halls is limited to clocks, small refrigerators, small radios and stereos, fans, shavers and small hair dryers. ELECTRICAL HEATERS AND ELECTRICAL COOKING APPLIANCES ARE NOT PERMITTED. If these items are found in your room, they will be confiscated. SURGE PROTECTORS ARE THE ONLY ELECTRICAL EXTENSION CORDS THAT ARE AUTHORIZED. 16. ENTRANCES / EXITS: The side and rear doors of residence halls are not to be used except in emergencies, e.g., fire, fire drills, emergency evacuations, and other times specifically designated by the Residence Hall Administrators or Emergency Response Personnel. Failure to comply with Fire & Safety policies will result in fines and/or removal from the residence hall. 17. CANCELLATION of ASSIGNMENTS (Have not checked into the residence hall) Cancellation notifications must be submitted in writing to reslife@vsu.edu or: o Department of Residence Life Campus Box 9073 Virginia State University, Virginia 23806 This Agreement is binding; therefore, students who have not cancelled this Agreement in writing and the written cancellation has been received by the Housing Office by May 16 for fall housing or November 16 for spring housing will be bound by this Agreement. Canceling a room assignment after the aforementioned deadlines will result in forfeiture of the room damage deposit. Students who cancel their housing assignment after the designated deadline will be accessed charges for the Page 6 of 8

time the student is in possession of the room. Having possession of a room includes having current housing assignment, having possession of the key to the assigned room and/or having personal belongings in the assigned room. 18. WITHDRAWAL / VALIDATION Students who officially withdraw, or are released from the University or Housing (during any session) within the first five calendar days of the beginning of classes and are VALIDATED or NOT VALIDATED will be charged a prorated room and board fee for the number of days in the residence hall. They are NOT eligible for a refund of any deposits. Students who officially withdraw, or are released from the University or Housing (during any session) after the fifth calendar day from the start of classes, and are VALIDATED will be charged the ENTIRE Room Rate for the semester and a prorated Board Rate, based on the exit date. They are NOT eligible for a refund of any deposits. Students who officially withdraw, or are released from the University or Housing (during any session) after the fifth calendar day from the start of classes, and are NOT VALIDATED will be charged the PRORATED rate for room and board up until the date the student vacates. They are NOT eligible for a refund of any deposits. Students who are required by the University to depart the residence hall for reasons of misconduct will not receive a refund for unused room charges; however, the dining plan (meals) will be prorated. They are NOT eligible for a refund of any deposits. Students who submit a Room Cancellation and/ or Withdrawal form must vacate the residence hall the day the form is submitted. Cancellations of the Housing and Food Service Agreement forfeit a student s room damage deposit. 19. EXITING THE RESIDENCE HALL Students must complete an Entrance/Exit Form when checking into a Residence Hall, and prior to departing the Residence Hall. Students vacating the residence halls during a semester, but who plan to return the next semester, must submit a new housing and food service agreement. Students who fail to properly turn in their key at the end of the Agreement and/or prior to any departure will be charged the cost of changing the lock. When a room is permanently vacated, the residents are responsible for returning the room and its contents to its original and satisfactory condition. Failure to do so will result in charges to the resident(s) of the room. 20. TERMINATION OF AGREEMENT: The University may terminate this Agreement and take possession of the room at any time for violation of the provisions herein, for violation of any federal or state law, University regulation, or for health or administrative reasons. Page 7 of 8

SIGNATURE PAGE Initial beside each of the following statements: I understand that if I fail to check-in by the stated Move-In Deadline, I will forfeit my Room Assignment (Section 8). I understand that I assume possession of the residence hall when I receive my key. Not staying in my housing assignment does not remove my financial responsibility for the cost of room and board. I understand that if I choose to cancel this assignment, I must do so by the stated cancellation deadline in order to be eligible for a housing room deposit refund (Section 17). I understand that if I withdraw from the University while validated after the fifth day of classes, I will be charged the entire rate for Room, and a prorated rate for meals (Section 18). I understand that if I withdraw from the University while not validated, I will be charged a prorated amount for Room and Board, based on the date that I exit the Residence Hall (Section 18). I understand that room change requests will only be honored during the Official Room Change Period (Section 9). I understand that in order to protect the health, safety, and welfare of the University and its entire campus community, the University reserves the right for authorized representatives to enter residence hall rooms at any time for the purpose of inspection, repair, and/or building maintenance, the maintenance of order and decorum, compliance with University policy and this Agreement, and compliance with federal, state and local laws (Section 15). By signing below, I understand that I am entering into a LEGALLY BINDING agreement with VSU and acknowledge that I will abide by: (1) the regulations of the University set forth in the current edition of the Student Handbook; (2) the regulations set forth in the Housing and Food Service Agreement; (3) the regulations set forth in the Department of Residence Life s Guide to Community Living; (4) the provisions outlined by the managers of Campus Dining Facilities; and (5) the Rules and Regulations outlined by staff members of the individual Residence Hall Communities. The provisions of this Agreement may only be waived or modified in writing by the Director of Residence Life. Student Signature Date Parent/Guardian Signature Date (If student is under age 18) Page 8 of 8