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(social security # is NOT required for International Students)
Social Security #
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Date of Birth:
Permanent Home Address
Primary E-Mail Address:
Secondary E-Mail Address:
School & Housing Information
[ Academic and Annual Pricing ]
Academic Year License (Aug-May, 9.5 Months)
Annual License (Aug-Aug, 11.5 Months)
1 Semester Only
Status Upon Move-In:
Terms & Conditions
I, the Applicant, represent that all of the above information has been provided by me and is true and complete. I understand that any misrepresentation made in the Application may be cause for the rejection of this Application and/or the termination of the License Agreement. Applicant further authorizes the exchange of information between Brooklyn College and other City University of New York institutions and RHBC Management, relating to the applicant's student status, academic records, judicial records, and financial records to be used to determine whether this application shall be approved or disapproved.
Completion of this Application does not guarantee the Applicant a space in Residence Hall.
* I, the Undersigned Applicant, have read and agree to all terms and conditions set forth in this application.
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