University of California, Santa Cruz

Student Housing Services

HOUSING CONTRACT AGREEMENT

Student Name: Shaw, Elijah D
Community: Oakes College
Application Period: Fall 2016 - Spring 2017

Student ID Number: 1534118

Age: 17

A parent or legal guardian must co-sign a Housing Contract Agreement form for any student who is under 18 years old at the time
the online housing application is submitted. To satisfy this requirement, return your signed form to the Student Housing Services
office within 14 days of submitting your online application. Fax your signed form to (831) 459-3665, or mail to:
Student Housing Services
104 Hahn Student Services Building
University of California, Santa Cruz
1156 High Street
Santa Cruz, CA 95064
LEGALLY BINDING CONTRACT
Once a student's housing application is confirmed by the university the application becomes a legally binding contract
that is valid for the entire academic year.
CONTACT INFORMATION
In order to communicate necessary housing business, housing staff may contact student at her/his UCSC email address.
Student is responsible for checking this account on a regular basis (email.ucsc.edu). Student is also expected to regularly
update personal contact information (address and phone numbers) via the student portal (my.ucsc.edu).
ROOM/HOUSING/THEME OPTIONS
The university will make every effort to honor the preferences expressed in the online application, however, a specific
college/housing facility, room type, or roommate assignment cannot be guaranteed.
MEAL PLAN OPTIONS
Student will be bound by the meal plan requirements of the facility to which they are assigned.
BILLING OPTIONS
As part of the online housing application, student has requested either quarterly or monthly payments for housing/dining
charges. Refer to the Terms and Conditions of residence for a full description of each billing option and eligibility.
State and federal laws govern the disclosure of information from student financial records maintained by the university.
Financial information cannot be discussed or released to any third party, including parents or legal guardians, without
student consent. Student may authorize another person to discuss housing/dining charges with the Campus Housing
Office by completing a Release of Billing Information at studenthousing.ucsc.edu.
Student certifies that her/his statements made in the online application are true and correct; that the Terms and Conditions of
residence have been read, understood, and agreed to, and that they are incorporated herein by reference; that the
application/contract is for the entire academic year; and that the signatures appearing here are valid. It is understood that any
misrepresentations or false statements appearing in the online application are material to this contract and constitute a breach
thereof.
Student Signature:________________________________________________________ Date: _____/_____/_____
Parent/Guardian Signature:_________________________________________________ Date: _____/_____/_____

STUDENT HOUSING SERVICES USE ONLY

SHO

CHO Initials__________

Date__________