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(Put N/A if none)
(Put N/A if none)
(Put N/A if none)

Parent/Guardian Contact Information

Automobile Information

(A yes answer will not automatically disqualify you from the dorms but further explanation may be required.)


The Application fee is not refundable. Grants, student loans and scholarships may not be used for the fee.

Arrangements to pay for room and board must be made prior to registration.

If withdrawal occurs during a semester, no refund will be made for room rent after 30 days. However, the
board charge will be refunded on a pro rata basis computed to the end of the week when the official withdrawal is completed.

It is the policy of Cisco College to provide equal employment, admission, and educational opportunities
without regard to race, color, religion, national origin, sex, age, or disability.

Cisco College provides separate residence halls for men and women residents. No married student housing is provided.

Please read the following prior to signing below.

While a resident student at Cisco College, I agree to conduct myself in a manner acceptable in an
educational environment and polite society. I understand that the college has dormitory rules
and regulations. I agree to abide by the rules and regulations of the college as set forth in the
Dormitory Handbook and Student Handbook. I understand that an infraction of the college
policy will result in an appropriate disciplinary action that may include the immediate eviction
from campus housing (without refund) and the refusal of future dormitory residency.

Arrangements to pay for room and board must be made prior to registration.

If withdrawal occurs during a semester, no refund will be made for room rent after 30 days.
However, the board charge will be refunded on a pro rata basis computed to the end of the
week when the official withdrawal is completed.

It is the policy of Cisco College to provide equal employment, admission, and educational
opportunities without regard to race, color, religion, national origin, sex, age, or disability.

Cisco College provides separate residence halls for men and women residents.
No married student housing is provided.

Please read the following prior to signing below.

While a resident student at Cisco College, I agree to conduct myself in a manner acceptable in an
educational environment and polite society. I understand that the college has dormitory rules
and regulations. I agree to abide by the rules and regulations of the college as set forth in the
Dormitory Handbook and Student Handbook. I understand that an infraction of the college policy
will result in an appropriate disciplinary action that may include the immediate eviction from campus
housing (without refund) and the refusal of future dormitory residency.

If under eighteen years of age, parent or legal guardian must sign.
A room will not be reserved without the following: