Residence Application Form | Services | University of Prince Edward

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ENTER
INFORMATION IN
CAPITAL LETTERS.
Residence Application Form
First Name: *
YOUR FIRST NAME
All fields marked with
an * are required.
Middle Name:
YOUR MIDDLE NAME IF YOU HAVE ONE
Last Name: *
Bernardine Hall
YOUR FAMILY NAME
Student ID (if known):
Permanent Mailing Address
Street address: *
2-17-1 OOMARU
City / Town: *
YOKOHAMA, NAKA-KU
Province / State: *
KANAGAWA
Country: *
JAPAN
The International Dialing Code
for Japan is 81 .
The 0 in the area code for Tokyo
and Yokohama is dropped when
dialing the number from
overseas .
Check for changes to your area
code when dialed from overseas.
Postal / Zip Code:
223-XXXX
Home Phone:
81-X-XXXX-XXX
Cell Phone (mobile/current):
Email: *
XXXX@XXX.jp
Date of Birth:
Month
Day
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University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |
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Residence Application Form
Academic
Residence @ UPEI
Application Type:
Having a problem with this form?
New UPEI Residence Student
Contact UPEI Residence
Returning UPEI Residence Student (lived in Residence for 2010/2011)
UPEI Residence Experience
Applying for:
Bernardine Hall
January 2011 - April 2011
September 2011 - April 2012
I'm attending: *
UPEI
Holland College
Other
Faculty:
Arts
Are you a:
Undergraduate Student
Academic Year:
1st
2nd
3rd
4th
Other
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University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |
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Residence Application Form
Preferences
Residence @ UPEI
Living Area
Please Note: Priority for Blanchard Hall is given to Upper Year, Transfer and Mature
Students.
1st Preference: *
Bernardine Hall
Bernardine Hall Co-ed Floor Single Room
Having a problem with this form?
Contact UPEI Residence
EXAMPLE
Bernardine Hall Co-ed Floor Double Room
Andrew Hall 2 Bedroom Suite
Andrew Hall 3 Bedroom Suite
Blanchard Hall Regular Area
Blanchard Hall Quite Area
2nd Preference (different from above):
Bernardine Hall Co-ed Floor Single Room
Bernardine Hall Co-ed Floor Double Room
Andrew Hall 2 Bedroom Suite
Andrew Hall 3 Bedroom Suite
Blanchard Hall Regular Area
Blanchard Hall Quite Area
3rd Preference (different from above):
Bernardine Hall Co-ed Floor Single Room
Bernardine Hall Co-ed Floor Double Room
Andrew Hall 2 Bedroom Suite
Andrew Hall 3 Bedroom Suite
Blanchard Hall Regular Area
Blanchard Hall Quite Area
Sex: *
Male
Female
Do you want to live on all female floor:
Yes
No
If available, and only based on student demand and interest, would you like to
Live in a quiet only section / floor:
Yes
No
Live in a alcohol free section / floor:
Yes
No
If you have no
roommate
preference, leave
these blank.
Roommate Preference(s)
Please note to be considered a valid request your name must also appear on their
application.
1st Preference:
Roommate
requests are not
guaranteed.
2nd Preference:
You can request to be
roomed with a friend. You
put your friend's name
here, and your friend
MUST put your name on
their application.
UPEI Residence Experience
Room Number Preference(s)
Please note room number preferences are for returning students only.
1st Preference:
2nd Preference:
Do not fill in.
3rd Preference:
Meal Plan Preference
Please note as a student applying to either Bernardine Hall or Andrew Hall you must
choose either a 5 day (Monday to Friday) or 7 day meal plan.
I choose a:
7 day meal plan
5 day meal plan
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UPEI Student Union
Accounting Office
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Residence Life
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University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |
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Residence Application Form
Personal Profile
Please note personal profile information is used in roommate matching. Please complete as
accurately as possible.
Residence @ UPEI
Having a problem with this form?
Contact UPEI Residence
I smoke:
EXAMPLE
Yes
Bernardine Hall
No
UPEI Residence Experience
I can live with a smoker:
Yes
No
I drink alcohol:
Yes
No
I prefer a roommate:
Who drinks
Who does not drink
No preference
I prefer my room:
Very neat
Somewhat neat
Carefree
I like to socialize:
a lot
sometimes
never
I like to go to sleep:
before midnight
after midnight
I wake up:
early a.m.
late a.m.
I listen to music:
a lot
sometimes
not often
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Search Faculty & Staff
Robertson Library
Webster Centre
Accounting Office
Off-campus Housing
Telephone Directory
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Contact UPEI
Student Services
Campus News and Events
Wireless Access
The Semantic
The Cadre
UPEI Student Union
Comptroller's Office
Enterprise Resource Planning
Procurement
Residence Life
Student Union
University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |
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Residence Application Form
Other information:
Use this space to give UPEI Residence other information on your
room or roommate preferences, or on your lifestyle that you haven't
given in the previous pages.
Please read the information below before submitting this form.
Bernardine Hall
Residence @ UPEI
Having a problem with this form?
Contact UPEI Residence
UPEI Residence Experience
Submitting this form indicates that the student ahs read and understood the goals of Residence Life at the University of
Prince Edward Island (UPEI) and agrees to be a positive contributor toward the achievement of these goals, should the
student be offered admission to the Residence Program at UPEI. It also certifies all of the information on this
application form to be true. If for any reason the information is found to be false, your offer of admission to the UPEI
Residence Life Program may be altered or rescinded.
To view the Residence Life Handbook: click here
Should the student accept an offer to the Residence Program, the submission of this form is evidence of an agreement
between the student and the University of Prince Edward Island, and is deemed to take effect at the time the student
registers for Residence.
The Residence Office reserves the right to: (1) balance upper-year/first year populations and male/female ratios in
residence buildings and on residence floors; (2) allocate rooms independent of this process under special
circumstances; (3) deny applications for re-admittance to the UPEI Residence Life Program.
This application is for residence accommodations only and does not guarantee your acceptance to the University of
Prince Edward Island or related Professional Program. If you have not applied to the university or a related professional
program offered by the university, you are required to do so before your residence application will be processed.
To complete an application for UPEI please visit www.upei.ca/futurestudents/apply or contact the Registrarʼs Office at
(902) 566-0439 to request a paper application.
(Please note that some programs do have additional application requirements. For more information, please visit:
http://www.upei.ca/registrar/calendar_toc#application)
Students attending Holland College or Maritime Christian College are not required to apply to UPEI to have their
residence application processed. Please be advised that priority for residence accommodations is given to UPEI or
related professional program applicants. All remaining residence applications will be processed based on availability
typically beginning in mid-July.
The University of Prince Edward Island recognizes the importance of protecting an individual's personal information.
Personal information will not be used or disclosed for purposes other than those for which it was collected, except with
the consent of the individual or as required by law. Further inquiries may be directed to the University's Privacy Officer.
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Health Centre
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Robertson Library
Webster Centre
Telephone Directory
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Contact UPEI
Student Services
Campus News and Events
Wireless Access
The Semantic
The Cadre
UPEI Student Union
Accounting Office
Off-campus Housing
Comptroller's Office
Residence Life
Enterprise Resource Planning
Procurement
Student Union
University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |
Prospective Students
Current Students
International Students
Alumni & Friends
Staff & Faculty
Contacts
SERVICES
Residence Application Form
Thanks for your interest in UPEI residence.
Please Note:
You should receive an email confirming receipt of your application within 2 weeks of submission
Go back to the form
Residence @ UPEI
Having a problem with this form?
Contact UPEI Residence
UPEI Residence Experience
Bernardine Hall
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My Moodle Courses
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Weather PEI
Jobs PEI
Academic Calendar
Financial Information
Registrar's Office
Important Calendar Dates
The Weather Network
Student Campus Jobs
Programs & Courses
Health Centre
Robertson Library
Financial Services
Housing
Search Faculty & Staff
Robertson Library
Webster Centre
Accounting Office
Off-campus Housing
Telephone Directory
Scholarships and Awards
Writing Centre
Board of Governors
Security Services
Contact UPEI
Student Services
Campus News and Events
Wireless Access
The Semantic
The Cadre
UPEI Student Union
Comptroller's Office
Enterprise Resource Planning
Procurement
Residence Life
Student Union
University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, Canada C1A 4P3 |