hall_application_form.pdf
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THE UNIVERSITY OF THE WEST INDIESMONA CAMPUS
OFFICE OF THE CAMPUS REGISTRARHALL OF RESIDENCE APPLICATION FORM
ACADEMIC YEAR 2010/2011
New Students (Full Time only)
Kindly fill in the form using BLOCK letters.
Completed forms MUST be sent directly to the desired Hall of Residence.
Personal Information
UWI ID/ Registration No. ____________________________________
SURNAME: ____________________________________
FIRST NAME : ____________________________________
HOME ADRESS: ______________________________________________________(Including Country)
______________________________________________________________________________
Mailing Address (if different from above:
______________________________________________________________________________
GENDER: Female/ Male DATE OF BIRTH: __________________________dd/mm/yy
TELEPHONE: _______________________ ________________________ (Home) (Mobile)
E-MAIL: __________________________________________________________________
Person to be contacted in case of an emergency:
NAME : _____________________________________________________________________
RELATIONSHIP TO APPLICANT: _______________________________________________
ADDRESS: ___________________________________________________________________
TELEPHONE : ______________ _____________ _______________________(Home) (Mobile) (E-Mail)
Do you have any known medical condition or physical disability? ________________________
If yes, please state: _____________________________________________________________
Family Physician: _______________________________________________________________
Contact: _____________________________________________________________________
High Schools/Tertiary Institution attended: __________________________________________
______________________________________________________________________________
Co Curricular Activities: ______________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Academic Information
Postgraduate Undergraduate
FACULTY ______________________________________
PROGRAMME/COURSE OF STUDY ____________________________________
Hall Information (Please tick the appropriate choices)NAME HALL TYPE
Mary Seacole Hall
UWI Mona, Kingston 7
[email protected]: 1-876-935-8483
Female Only
Chancellor Hall
UWI Mona, Kingston 7
Tel: 1-876-927-2780
Fax: 1-876-970-3554
Male Only
A.Z. Preston Hall
UWI Mona, Kingston 7
Tel: 1-876-977-6721-3
Fax: 1-876-927-1600
Male and Female
Irvine Hall
UWI Mona, Kingston [email protected]
Tel: 1-876-927-2793-4
Fax: 1-876-927-2754
Male and Female
Taylor Hall
UWI Mona, Kingston 7
Tel: 1-876-927-2533
Fax: 1-876-927-2533
Male and Female
Rex Nettleford Hall
UWI Mona Kingston 7
[email protected]: 1-876-977-60833 / 1-876-977-0214
Fax: 1-876-977-5644
Male and Female
Western Jamaica Campus Hall
Tel: 1-876-940-4349
Fax: 1-876-971-1283
Male and Female
Have you ever lived in a hall of residence/dormitory before? Yes No
Was it a hall of residence at UWI, Mona? Yes No
If Yes state which one: __________________________________________________________
State the period for which you previously stayed in hall (if applicable): ___________________________
*Students who have been accepted to the University, and who requested Hall Accommodation must
contact the Hall to which they applied to verify their accommodation status. Students must notify
the Hall immediately if accommodation is no longer required. Please be advised that only full time
students are eligible to apply for room in a Hall of Residence.
I UNDERSTAND AND AGREE THAT:
(1) Acceptance to the University does not guarantee an assignment to a room.(2) The Universitys regulation on conduct and policies under which housing facilities are
operated must be observed at all times during the period of residence.
(3) It is my responsibility to update my contact information.(4) If I fail to respond to ANY correspondence from the Halls of Residence by the stated
deadline my application will be cancelled.
(5) Persons who have been offered and accepted a place in a hall will only be guaranteedaccommodation for a period of one academic year, providing that all terms and conditions
of the Hall Agreement and Tenancy are adhered to.
Date: _________________ Signature: ________________________ _______