Laurel House Membership Application

How to apply: Fill out the application completely and submit it. Upon acceptance a contract will be mailed or handed to you to sign and return along with your $300 deposit and $50 membership fee.

First MI Last
Date of Birth Driver License # State
Social Security # Today’s Date
Permanent Address
City State Zip Code
Permanent Phone Current Phone
Current Address
City State Zip Code
Email Address

Have you ever lived in a housing cooperative? Yes No
Have you ever been evicted from a place of residence? Yes No

Do you have any special medical/dietary needs we should know of?

Name, address, and phone number of person to contact in case of emergency?

Please mark the houses you are applying for.
21st Street Laurel Opsis Pearl Taos

I am apply for : Fall/Spring Spring Only Summer I/II

Preferred room : Single Only Double Only
Single but will accept a Double Double but will accept a Single

I am :

Male Female
Non-Smoking Smoking
Freshman Sophomore Junior Senior Graduate Faculty/Staff

Please rate yourself on the amount of noise you make. (Be realistic)

Quiet		Noisy

Using the same scale how much noise can you tolerate?

Quiet		Noisy

How did you hear about College Houses Cooperatives? (Mark all that apply)
Mailing Newspaper Ad Friends Walked By UT info Other

At College Houses you will be living and working along side people from diverse sexual orientation, religious, racial cultural, social, and ethnic backgrounds. Do you for see this as a problem?
Yes No
Please explain if necessary

Living in a co-op is not like living in a dorm or apartment. You will be part of a community. All members are to participate in 1-2 house meetings a month, co-op committees, and perform 1-6 hours of weekly duties. These duties are very important and vital to good house operations. Are you willing to accept these duties and do them responsibly?
Yes No
Please explain if necessary

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

What contributions do you think you can make to this living style?

Please describe yourself (i.e. major, hobbies, interests, goals, background, etc.)

What will be your sources of income to pay College Houses? (Mark and fill in all that apply)

Financial aid, savings, or other: You may be asked to provide further information later.
Parents, legal guardian, or other: Please give name, address, and phone number.
Income from job: Please provide employer and phone number.

Application for Membership