International Exchange Student Housing Application

First/Given Name *

Family Name/Surname: *

Gender *

Male Female

Centenary visit:

only Fall Semester 2013 only Spring semester 2014 Fall and Spring semesters 2013-2014

Email *

Centenary Student ID # (if known)

This “Campus Housing Agreement” is a formal understanding entered into by the student and Centenary College of Louisiana. The agreement is binding for the entire duration of the semester(s) of the international exchange visit unless the student withdraws from Centenary College of Louisiana. Under no circumstances are international exchange students eligible to live off campus.

I hereby acknowledge that I have read the “Campus Housing Agreement Terms and Conditions” which are listed at the bottom of this form. Furthermore, I hereby agree to be legally bound to the “Campus Housing Agreement Terms and Conditions” as stated.

Campus Housing Agreement Terms and Conditions *

By checking this box, I hereby agree to be legally bound to the “Campus Housing Agreement Terms and Conditions” as stated.

FOR STUDENTS UNDER THE AGE OF 18 as of Aug. 21, 2013: The undersigned parent/guardian of the named student does hereby guarantee that the student will fully perform and abide by the “Campus Housing Agreement Terms and Conditions” and hereby indemnifies and agrees to hold harmless Centenary College of Louisiana against any loss, claims, obligations, liabilities, costs, expenses, and reasonable attorney’s fees arising from the student’s failure to perform or abide by such agreement.

Guardian's First/Given Name

Guardian's Family/Surname

CAMPUS HOUSING AGREEMENT TERMS & CONDITIONS

Centenary College of Louisiana does hereby agree:
1. To provide to the student a room in a Centenary College operated residence hall/house.

2. To provide a standard meal plan to the student in the Centenary College dining hall. Sodexho will make every effort to address special
diet concerns; however, there are no allowances or refunds for special diets/considerations that cannot be accommodated.

3. That this agreement does not include room/board accommodations during vacations/recess periods listed in the Centenary College
Catalog.

4. Not to discriminate in room/hall selection/assignment on any basis. A reasonable attempt will be made to meet the student’s housing
preference; however, a failure to honor a preference will not void this agreement.
The Student does hereby agree:

1. To make payment for these accommodations to Centenary College in accord with the published payment schedules.

2. That continued compliance with Centenary College policies, procedures, guidelines and standards is a condition of this agreement.
Centenary College policies are printed online and in residential life publications. A violation of this condition, or any section of this
agreement, is subject to disciplinary action and will also allow Centenary College to terminate this agreement at its sole option. An
election by Centenary College not to exercise this option does not waive the exercise of this option in the event of
continuing/subsequent violations.

3. To utilize the assigned room only as a personal living area and that no commercial or unlawful operations shall be carried on therein.

4. To adhere to the published opening and closing dates. At the end of each semester, the student agrees to vacate the halls within 24
hours of their last exam or before the designated closing date/time.

5. At the termination/completion of this agreement, the assigned room will be left in the same condition, with the same furnishings,
provided at the time of arrival to the room and hall.

6. To be responsible for damage beyond normal wear to the student’s room/unit and for any other on-campus damage caused by the
student. If damage occurs in the room for which the responsible individual(s) cannot be identified, all residents of the room shall
share equally in the financial responsibility for the damage.

7. That all personal belongings left by the student at the completion of his/her residency under terms of this housing agreement will be
disposed of by Centenary College with the student charged $100.00 for additional maintenance service.
Moreover, it is mutually agreed upon:

1. This agreement constitutes a formal, legal understanding and not a tenant lease.

2. That Centenary College has no responsibility for the theft, loss, or destruction of property belonging to, or in the custody of the student.
Each student is advised to carry his or her own property insurance.

3. That Centenary College reserves the right
to inspect rooms and regulate the use of the premises according to Centenary College policy.
Additionally, Centenary College reserves the right to enter room/units for making routine repairs during the normal workday and
in emergency or policy violation situations.

4. That execution and performance of this agreement by Centenary College is conditional upon the student fulfilling the admissions,
registration, and academic requirements of Centenary College.

5. This Campus Housing Agreement is signed and binding for the entire academic year . Any release from this agreement is permitted only
under the conditions of academic withdrawal, dismissal, verified medical reasons or other extreme extenuating circumstances,
and only with the written approval of the Director of Residence Life. Any request for release must be submitted in writing to the
Director of Residence Life and will be evaluated on a case-by-case basis in Centenary College’s sole discretion. Any refunds will be
in accordance with the refund policy set forth in the Centenary College catalog.

6. That room & board charges WILL NOT BE REFUNDED:
1. if the student changes place of residence to non-Centenary College operated
housing;
2. if the student is evicted from the residence halls for disciplinary reasons.

7. That the residence hall/house accommodations are available only to full-time (pursuing at least 12 credits per semester) students
enrolled at Centenary College. Exceptions must petition the Director of Residence Life in advance.

8. That Centenary College reserves the right to assess a fee (150 percent of regular room rate) per semester surcharge to a student residing
in a single room, should the student be offered this option or same result from students’ inability to secure a roommate.

9. That Centenary College reserves the right to assign/reassign rooms for the benefit of the community as determined by Centenary
College. In order to use Centenary College housing space effectively, Centenary College reserves the right to reassign individuals to
consolidate space. The Director of Residence Life will reassign the -student if the student has not located a roommate within 10
days of notification by the Office of Residence Life.

10. That Centenary College has the right to make changes to its Room & Board charges and or housing fees, as determined by the
Centenary College Board of Trustees.

11. That the occupants of each hall/area will be held financially accountable, as a group, for damages beyond normal wear to the building
common areas and its furnishings in the event responsible individual(s) have not been identified as having caused the damage.

12. To ensure the security of the residence hall lock/key system the student agrees to maintain all issued keys in her/his possession at all
times; not duplicate Centenary College issued keys; and shall return all issued keys upon checkout.

13. If any provision of this agreement is determined invalid or unenforceable, it will not affect the validity or enforcement of the remaining
provisions herein.

14. That this agreement is made and is to be construed in accord with the laws of the State of Louisiana.

MEAL PLAN 2013-2014

Meal Plan Options (required for all students living on campus and optional for commuter students):

Cent Bucks Centenary Dollars (or Cent Bucks) can be used in Randle’s (campus snack bar) or to purchase a meal in the Caf (campus
dining room). Additional Cent Bucks can be purchased in $25 increments any time during the academic year.

Lose your Meal Card (ID Card)? If you lose your ID card, you can get it replaced through the Department of Public Safety (DPS)
for $25. Remember, without an ID card you have to pay cash for your meals.

Seconds Anyone? Our unlimited seconds policy allows for one entrée per service, but you can return as often as you like. We
emphasize that the feeding of friends or guests is not allowed without the purchase of a meal ticket.

Something Special? Need special meals or have a restricted diet? Notify the Food Service office and inform us of your special need.
We will be more than happy to comply with a written doctor’s request. However, additional foods or special food cost will be the responsibility of the students.

FULL MEAL PLAN, 3 OPTIONS: *

17 MEALS + $100 per semester 15 MEALS + $125 per semester 12 MEALS + $150 per semester

The full meal plan provides a combination of a certain number of meals per week with a corresponding number of Cent Bucks per semester to use like cash at the campus snack bar. The full meal plan is required for firstyear and sophomore students living on campus and is available to all students. The 17 meals + $100 is the best financial deal for the most food.

Academic Year: *

Major Field of Study:

LIST MEDICAL CONCERNS of which the housing staff should be aware:

All exchange students will be assigned to a double room in James Hall.

ROOMMATE MATCHING:

STUDY TIME:
I like to study earlier in the evening, before 9pm. *

Yes No

ROOM USE:
I prefer the room to be used for *

Studying Socializing Both

TIDINESS:
I like to keep the room: *

very neat neat somewhat messy messy very messy

SLEEP TIME:
I like to go to sleep before 11pm. *

Yes No

I like to get up before 8am. *

Yes No

SLEEP ENVIRONMENT:
I like to study/sleep with music/TV on. *

Yes No

I need it totally dark to sleep. *

Yes No

SMOKING: All buildings are smoke-free. If you smoke, you must go outside to do so.

I smoke. *

Yes No

I want to be placed with a non-smoking roommate. *

Yes No

OTHER THINGS I WOULD LIKE TAKEN INTO CONSIDERATION:

Centenary College of Louisiana

All exchange students will be assigned to a double room in James Hall. ROOMMATE MATCHING:

SMOKING: All buildings are smoke-free. If you smoke, you must go outside to do so.

All exchange students will be assigned to a double room in James Hall.

ROOMMATE MATCHING: