Pacific Union College | Reservation Form

Housing

Reservation Form

Please use the following form to register for your residence hall. Housing assignments are made following the receipt of the $150 room reservation fee. This fee may be paid by check or credit card. To pay by credit card continue to our online payment form after you submit your reservation. If you have already reserved your residence hall, but still need to pay, please visit our payment form.

*Indicates a required field

Info

*Beginning Quarter *:

ID Number:

Personal Info

*Gender:

Male
Female

*Student First Name *:

*Student Last Name *:

*Email Address *:

*Address *:

Address 2:

*City *:

*State/Province *:

*Zip Code *:

Country/Region:

*Home Phone *:

Cell Phone:

*Age *:

*Birth date:

(day/month/year)

Additional Info

Major:

*High School/Academy attended *:

*School last attended *:

Roommate:

Roommate's Phone:

Men's Residence Halls:
(Number in order of preference)

Grainger:

Newton:

Nichol:

Women's Residence Halls:
(Number in order of preference)

Andre:

Graf:

McReynolds:

Winning:

*Lifestyle *:
(Remarks regarding your musical taste, sleeping habits, room care, social habits.)

Residence hall assignment is based on availability, the date the
room deposit is received, and dean's discretion.