Housing Application: New Students (Inside the USA)

Please complete this form if you are a new ELI student who is already inside the USA.

By completing this housing application, the student agrees to the ELI Housing Terms and Conditions and agrees to pay all costs associated with the housing type that is assigned to him/her.

Click here to view housing types and fees.

Housing Application Form

*(denotes required field)

First Name: *

Middle Name:

Last Name: *

E-Mail Address: *

E-Mail Address again: *

Please enter your E-mail Address a second time.

Student ID#:

Date of birth: *

Gender: *

Agent Information

Enter your agent's information, if applicable.

Agency name:

Name of counselor:

Agent email:

Session Information

Please select the session for which you need housing.

Session#: *

Housing Choices

What is your first choice for housing?
We will try to reserve your first housing choice for you; however, since we have limited housing, you must choose 2 different housing types on this form.

First choice: *

Second choice: *

Signature

By submitting this form, I agree to the Housing Terms and Conditions listed on the ELI website. I understand that I must pay all costs associated with the housing type that is assigned to me.

Signature (type your name here): *

Housing Application: New Students (Inside the USA)

Housing Application Form

Agent Information

Session Information

Housing Choices

Signature

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