Now Accepting Applications!!!

Because of high demand, we are officially offering you a chance to reserve your room. Fill out the form below to take the first step in guaranteeing yourself and your roommates a suite experience, suite lifestyle and a suite apartment. What are you waiting for!!!!

 

If you have any questions or you need assistance with the application, please call Nick Ippolito 585. 205.1185.

 

Apply Below

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Reserve your room today!

A $75 Administrative Fee is required in advance to reserve a room at College Suites at Brockport. Please make a check or money order payable in U.S. dollars to UC Brockport Housing, LLC and mail it to College Suites at Brockport, 4599 Redman Rd Brockport, NY 14420. The $75 Administrative Fee assures compliance with the terms and conditions of College Suites a Brockport Student Housing License Occupancy Agreement which the applicant will receive once accepted as a resident of College Suites at Brockport. Please note that the $75 Administrative Fee is non-refundable.

 
Part One
Personal & Emergency Information
First Name
MI
Last Name
School Address
County
City
State
Zip/Postal Code
Home Address
County
City
State
Zip/Postal Code
Telephone #
Cell #
Email
Date of Birth
SSN
Emergency Contact
Name
Relationship
Daytime Phone
Evening Phone
Have you ever been convicted of a felony?    Yes   No
Have you ever been dismissed from another college?    Yes   No

Academic Information
 Freshman   Sophomore Junior Senior Grad Student Transfer Student
Term Begins  
Term Ends  
Check one that Applies
  9 Month Academic Year   Summer Term 2010
  Other Term  
Apartment Request
 4 bedroom/2 bathroom
 3 bedroom/2 bathroom
2 bedroom/1 bathroom *Very limited
Roommate Matching Information
  Male    Female    Smoker
Referred by/source
MySpace Facebook
Email Mycollegesuites.com
Snail Mail Campus Event
On Campus Posters Friend / Word of Mouth
I was referred by:
Parking space needed?   Yes   No
Requesting Disabled/Medical Accessibility    Yes    No  

Requested Apartment Roommates (optional)
Name   Name  
Name  

Listed roommates must request and agree to assignment.

Application Process Fee
Please enter your billing details below or use the PayPal Express option below
First Name:
Last Name:
Card Type:
Card Number:
Expiration Date:
Card Verification Number:
Billing Address:
Address 1:
Address 2: (optional)
City:
State/Province:
ZIP Code: (5 or 9 digits)
Country:
Amount: $75 + $2.25 processing fee

Students residing at College Suites at are expected to conduct themselves in a manner appropriate to an academic community living environment. I warrant that all statements above set forth, to the best of my knowledge are true and correct. I understand that deliberately submitting false information or withholding information constitutes fraud. Federal law specifies fines up to $10,000 and prison terms up to five years for fraud and may be grounds for eviction.

I also understand that this form is only an application for residency and that the submission of this application does not reserve nor in any way guarantee an apartment or bedroom.

 I understand and agree to the set terms above.
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