Housing Application v1 "*" indicates required fields Resident InformationFamily Name* First Name* Middle Initial UWest ID* Date of Birth* MM slash DD slash YYYY Gender*Please choose:MaleFemaleOtherMailing Address Street* City / Town* State / Province* Zip / Postal Code* Primary Phone* Cell Phone Email Address* EMERGENCY CONTACTLast Name* First Name* Relationship* Mailing Address Street* City / Town* State / Province* Zip / Postal Code* Primary Phone* Cell Phone Email Address* COVID-19 Vaccination InformationHave you been vaccinated against COVID-19?*Please choose:YesNoFirst Dose/Shot*Please choose:ModernaPfizerJanssen / Johnson & JohnsonAstraZenecaNovaVaxMedigen MVC-COV1901Sinopharm CoviloSinovac CoronovacSecond Dose/ShotPlease choose:ModernaPfizerJanssen / Johnson & JohnsonAstraZenecaNovaVaxMedigen MVC-COV1901Sinopharm CoviloSinovac CoronovacThird Booster Dose/ShotPlease choose:ModernaPfizerJanssen / Johnson & JohnsonAstraZenecaNovaVaxMedigen MVC-COV1901Sinopharm CoviloSinovac CoronovacVaccination Record*Please upload a copy of your vaccination record here.Max. file size: 100 MB.PricingFall 2022 Pricing (17 weeks/No Meals): Payable no later than August 1st, 2022. Note: Failure to pay by above deadline may lead to action by the university, including late fee assessments, termination of housing contract, and/or removal from housing. If you are requesting a payment extension due to the financial aid disbursement schedule please sign the Financial Aid Addendum attached with your application.Please choose:* Triple - $1,977 (must be fully vaccinated and boosted) Double - $2,602 (must be fully vaccinated and boosted) Single - $4,497 (must be fully vaccinated and boosted) Financial Aid AddendumIf you are requesting a payment extension due to the financial aid disbursement schedule please sign the Financial Aid Addendum attached with your application.Max. file size: 512 MB.Housing Contract LegalI Agree* HOUSING CONTRACT Meal services are not provided during the Fall 2022 Semester. In line with CDC, state, and county guidelines and in the interest of our residents’ and staff’s health and safety during the ongoing COVID-19 pandemic, all residents are required to be fully vaccinated and boosted against COVID-19 in order to live on campus. Residents must also receive the seasonal influenza vaccination when it becomes available, usually in the fall or early spring. By signing this contract, you agree that you are and will be enrolled as a current active full-time student throughout the remainder of the contract and/or upcoming semester for Winter Break contracts. By signing this contract, you agree to all university rules and policies. The campus will be closed on Federal holidays; services will be very limited during these days. (No mail services.) Once you submit the housing application, it is a legally binding contract for the entire semester between University of the West, hereinafter called “the University,” and the undersigned student, hereinafter called “the Student.” To be eligible to live in University Housing, students are required to be enrolled full-time in a degree or certificate program during the academic year. During summer and winter breaks, students must be enrolled in the previous and upcoming semester in order to be eligible to continue to live on campus during the break. With few exceptions, students who fall below full-time enrollment may forfeit their eligibility to live on campus and be required to move out immediately. Termination of Contract: This contract may be terminated by the Student only for the following reasons and only with prior written approval by the University (Residential Life Office), and the Student shall be assessed the appropriate liquidated damages fee: If the Student ceases to be a currently enrolled Student at UWest due to graduation, withdrawal, academic or administrative dismissal, transfer to another institution, or is a participant in a University authorized planned educational leave program. The Student must present official documentation as verification and return all assigned keys to the Residence Hall Coordinator. If the Student marries during the Contract term and presents proof of marriage by means of a notarized state marriage certificate, the Contract shall be terminated on the date that said evidence is provided to the University (the Residential Life Office) and on the return of all check-out forms and assigned keys to the Residence Hall Coordinator. Requests for termination for reasons other than those listed above will be considered only with written approval by the Residential Hall Coordinator. If the Student is not approved for dissolution of their contract, then the Student shall remain liable for all room and board fees until the day of release. COVID-19 PROVISIONS All students living on campus must be fully COVID -19 vaccinated and boosted. Those arriving from outside the U.S. who are not fully vaccinated and boosted will need to present a negative COVID-19 result in order to move into quarantine housing, and proceed to get fully vaccinated and boosted as soon as they finish quarantining. In light of the health and safety crisis created by the COVID -19 pandemic, the University continues to implement and periodically update various health and safety programs, procedures, and safeguards relating to University residential arrangements and contracts. Students will be required to undergo COVID-19 testing and submit the results thereof to the appropriate University official whenever testing is deemed in the best interest of the campus community. Students must follow any new LA County, California, or Federal COVID-19 guidelines and policies. Housing contracts for new residents are granted on a case by case basis in light of the fluid public health emergency. The University reserves the right to limit resident population as necessary to protect the health and well-being of our campus community, which may result in the delay or halt of new move-ins. While we will do our best to reduce any resulting inconvenience, applicants are advised to plan accordingly. In order to be eligible to live in University Housing, students must present proof of full COVID-19 vaccination and booster. Residents arriving from outside the U.S. who were unable to receive vaccination prior to traveling are required to present a negative result from a COVID-19 test taken within three days of arrival on campus and to quarantine in rooms set aside for that purpose and to follow the quarantine requirements exactly. During quarantine, the Student is required to perform daily health checks for fever, cough, and other signs and symptoms associated with COVID-19. A Residence Hall staff member will check in daily with the Student, and the Student is required to notify the University if they are experiencing COVID-19 related symptoms. The University will determine the need to quarantine on a case by case basis and provide separate detailed instructions and information regarding the requirements for quarantine. Students seeking to move onto campus should contact Residence Hall Coordinator Eddie Bernal, firstname.lastname@example.org, as soon as possible so that the University can make the necessary determination and arrangements. Students unwilling or unable to comply with COVID-19 provisions will not be allowed to move into campus housing. In order to facilitate, and in consideration of the University’s efforts to provide, the University’s COVID-19 safety efforts, the Student agrees to comply with the following COVID-19 provisions, which may include: Wear a mask or face covering when leaving their room; Follow guidelines that prohibit guests (including other students) in the Residence Halls; Adhere to rules that limit residents to portions of their Residence Halls, including using only assigned restrooms, entrances, stairs or elevators, and common areas; Adhere to guidelines about physical distancing and avoiding large gatherings; Reasonably monitor one’s health status including potential symptomology, and report virus symptoms promptly to the Residence Hall Coordinator; and Self-quarantine or isolate, if potentially exposed to or infected by COVID-19, for the number of days required by Los Angeles County, in accordance with University, Centers for Disease Control and Prevention (CDC) and State guidance. Residents must be able to independently follow the directions of University officials if required to quarantine or isolate, including moving to a different facility for the duration of the quarantine or isolation. Residents must be able to use a mask or facial covering when outside their room. Residents must be able to frequently and consistently wash their hands and use hand sanitizer containing 60%+ alcohol. Residents must be able to frequently clean their own room using EPA registered household disinfectants. Residents must be able to regularly launder personal items. By checking this box, I attest that I have read and agree to the housing contract.Additional One Time FeesHousing Application Fee (new residents only)*Non-refundable fee for processing and delivering mail. $50 Housing Security Deposit*NOT included in the total cost of Room & Board; this fee is refunded at the end of the year if no damages are incurred $200 Mail Processing Fee* Non-refundable fee for processing and delivering mail. $20 / Semester SignatureBy signing below I attest that all information I have provided on this agreement is accurate and correct. I have read and understood the Residence Hall Community Guidelines contained in this agreement. I understand that any violation of the Residence Hall Community Guidelines or the University's policies may result in disciplinary action, including but not limited to removal from University housing and dismissal from the University. I also understand that this contract is not binding until signed by myself, a parent, or a guardian if I am under the age of 18, and an authorized University official. Resident understands and acknowledges that, despite the health and safety measures that the University is instituting to protect staff, faculty, and students from COVID-19, an inherent risk of exposure to COVID-19 exists in any public place or congregant living arrangement where people are present. COVID-19 is an extremely contagious disease that can lead to severe illness and death and returning to/living on campus may expose Resident, and possibly members of Resident’s household (through Resident), to a variety of hazards and risks foreseen and unforeseen related to COVID-19. Resident is electing to live in UWest housing with full knowledge and understanding of those hazards and risks.Student's Signature* Date MM slash DD slash YYYY A parent or guardian is required to sign below if the student is under 18 years of age.Parent/Guardian Signature Date MM slash DD slash YYYY PLEASE MAKE CHECK OR MONEY ORDER PAYABLE TO UNIVERSITY OF THE WEST Be sure to write the Student’s name and ID number on all checks or money orders. Payment will be accepted without the billing notice if the ID is written on the check or money order. Go online to www.uwest.edu for complete UWEST billing and payment information. Information for how to pay online can be found here:I Agree* By checking this box, I understand that submission of this application constitutes a legally binding agreement/contract and I will need to submit payment within 14 days.EmailThis field is for validation purposes and should be left unchanged.