Back to Southampton

SUMMER PROGRAMS
Summer Courses
Writers Conference
Studio Arts
Theatre
High School
 
Tuition and Fees
Academic Guidelines
Campus Facilities
Housing
Email
Registration Information
Request a Catalog
Important Numbers
 
Frequently asked questions

 

2005 Summer Housing Form
2005 Southampton Graduate Campus Application for Summer Housing Print out this form and complete all details. Return it to the Summer Office, Southampton Graduate Campus, Southampton, NY 11968-4198 along with your Summer Registration Form. You may also fax the completed forms to us at 631 287-8253.

If you have questions, call 631 287 8175 or send e-mail to summer@southampton.liunet.edu.

Name:

Home Address:


City/State/Zip:
Home Phone (with area code):

Name of Parent or Guardian (if under 18 years of age):

Class: __Freshman __Soph. __Junior __Grad. __Transfer __Other

Are you a matriculated student of Long Island University? __Yes __No
If so, what campus are you matriculated with (as of 5/01)?
If Southampton, Campus Box Number:

Social Security Number:

Sex: __Female __Male
Date of Birth:
Marital Status: __Single __Married

Course(s) registered for: 



Dept   Course Number        Course Title          Dates: From/To

Room Preference: __Double __Small Single
(NOT GUARANTEED --assigned on a first come, first served space availability basis)

___Smoking ___Non-Smoking

Mandatory Meal Plan* (Choose one):
(*not required of institute participants)
== __ 15 meals per week
== __ 12 meals per week
== __ 8 meals per week

[up]

-----------
SUMMER HOME

Back to Southampton | Back to Long Island University