ICC Co-op Housing Application Form

*First Name

*Last Name

*Date of Birth

*Age

*Gender
Select One Female Male Other

Home Phone

*Cell Phone

*Email Address

*Current Address

*Current City

*Current State

*Current Zip

*I will be at my current address until

*Permanent address or contact address after the above date

*City

*State

*Zip

*Applying for what Semester?
Select One Spring Summer Fall

*Year
Select One 2012 2013 2014

*Status for that semester
Select One Full-time student Part-time student Non-student

*School

*Class Rank
Select One Freshman Sophomore Junior Senior Graduate Non-student

Major

Please check one or more of the following as proof that you will be able to meet your financial responsibilities:

Other - If you have financial aid, a grant, scholarship, savings, or other form of financial support please select this option and mail or fax (512-476-3904) us a copy of the document.

*Do you know anyone who currently lives in ICC? (if yes, who?)

Current or former landlord (even if it's your parents)

Phone

Fax

Landlord listed above is my parents

*Have you lived in ICC before? When?

Room type
Select one private room only shared room only private but will take a shared shared but will take a private

House
Select One No preference Arrakis Avalon French House Helios House of Commons New Guild Royal Seneca Eden

Room #

Are there any other houses or rooms you are particulary interested in?

Please check any house you do NOT want to live in:

Any particular reason why you don't like those houses?

What kind of meals do you prefer?
Select One omnivorous mostly vegetarian vegetarian vegan

House of Commons is vegetarian/vegan. Seneca is mostly vegetarian. All other houses have a vegetarian option, except French House.

We do not automatically check applications for roommate compatibility. If you are applying for a shared room and have concerns about roommate compatibility please make sure you remind the ICC staff of smoking, pet, noise, and other preferences when you sign a lease.

Please list any other roommate preferences

Tell us about yourself! Please describe yourself and your personality. Include such things as interests, goals, personal habits, academic interests, and what you like to do in your spare time.

Living in a co-op is nontraditional living. You will be a part of a cooperative community. Members participate in at least 2 house meetings per month, perform 4-6 hours of weekly duties, and may serve on ICC committees. These duties are very important and vital to a positive living environment. Are you willing to accept these duties and perform them responsibly? Please elaborate.

In our housing co-ops you will be living and working alongside people from diverse orientations and backgrounds whose social, cultural, racial, ethnic, religious, and sexual identity and values may be different from yours. Do you think this will be a problem? Please elaborate.

What do you think are the advantages for you in a cooperative living environment as opposed to other forms of housing?

What contributions do you think you can you make to the co-op?