NEO A&M College Housing Application

Please complete this application to apply for housing at Northeastern Oklahoma A&M College. A $75 deposit is required for traditional dorms, $150 deposit is required for NEO Suites and Milligan Hall. A mandatory $15 PO Box deposit is required for both (refundable upon check-out) All deposits must be submitted with this application before a room assignment will be made.

I am applying for: *

I am applying for: Fall, August Spring, January Summer
Academic Year (i.e. 2021-22)
Name Name * First Last
Banner ID (Student ID#) *
Gender *

Gender Male Female
NEO Email address
Alternate Email
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
College Classification

College Classification Freshman Sophomore
Major
Date of Birth Date of Birth * / MM / DD YYYY
Age
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone * - ### - ### ####
Personal Email address (gmail, yahoo, etc.) *
Emergency Contact *
Emergency Contact Phone Number Emergency Contact Phone Number * - ### - ### ####
Do you prefer a private room (Traditional Only)

Do you prefer a private room (Traditional Only) Yes No
What type of music do you prefer?
Requested Roommate Name(s) (if applicable)
Are you a member of any organized NEO team?

Are you a member of any organized NEO team? Yes No
If yes, what team?
Are you neat and organized?

Are you neat and organized? Yes No
Do you go to bed early?

Do you go to bed early? Yes No
Do you like to sleep late?

Do you like to sleep late? Yes No

Housing Choices - Please indicate 1st, 2nd, and 3rd choice.
	First Choice	Second Choice	Third Choice
Dobson Hall (Traditional Female)	Dobson Hall (Traditional Female)First Choice	Dobson Hall (Traditional Female)Second Choice	Dobson Hall (Traditional Female)Third Choice
Harrill Hall (Traditional Female)	Harrill Hall (Traditional Female)First Choice	Harrill Hall (Traditional Female)Second Choice	Harrill Hall (Traditional Female)Third Choice
Vann Hall (Traditional Male)	Vann Hall (Traditional Male)First Choice	Vann Hall (Traditional Male)Second Choice	Vann Hall (Traditional Male)Third Choice
Russell Hall (Traditional Male)	Russell Hall (Traditional Male)First Choice	Russell Hall (Traditional Male)Second Choice	Russell Hall (Traditional Male)Third Choice
Dyer Hall (Scholarship Football Only)	Dyer Hall (Scholarship Football Only)First Choice	Dyer Hall (Scholarship Football Only)Second Choice	Dyer Hall (Scholarship Football Only)Third Choice
Suite Style 4 Bdrm (Co-Ed)	Suite Style 4 Bdrm (Co-Ed)First Choice	Suite Style 4 Bdrm (Co-Ed)Second Choice	Suite Style 4 Bdrm (Co-Ed)Third Choice
Suite Style 2 Bdrm (Co-Ed)	Suite Style 2 Bdrm (Co-Ed)First Choice	Suite Style 2 Bdrm (Co-Ed)Second Choice	Suite Style 2 Bdrm (Co-Ed)Third Choice
Milligan Hall (2 Bdrm Quad style)	Milligan Hall (2 Bdrm Quad style)First Choice	Milligan Hall (2 Bdrm Quad style)Second Choice	Milligan Hall (2 Bdrm Quad style)Third Choice

Have you ever been required to register as a sex offender (as an adult)? *

Have you ever been required to register as a sex offender (as an adult)? Yes No
If yes, please identify the year and state of your registration.
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
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