Summer Housing/Extended Stay Contract Form

Preference will be given to students who are taking KWC Summer courses or are employed by the College during the Summer. Summer housing occupants must have been enrolled at KWC or another educational affiliate during the prior Spring term in order to be eligible for Summer housing.
Your Name*
First Last
Your Permanent Home Address*
Street Address City State ZIP Code
Your Cell Phone Number*
Your Primary Email*
This is the email address where all communications will be sent.
Enter Email Confirm Email
Are you a KWC student?*
- Yes
- No
Your KWC Email*
Enter Email Confirm Email
Your College/University Address*
Institution Name Address City State Phone Number
Are you registered (or planning to register) for Summer/Fall classes at KWC?*
- Yes
- No
Employer Address*
Employer Name (Company Name) Address City State Phone Number
Is your billing address different than your permanent home address?*
- Yes
- No
Billing Address*
Street Address City State ZIP Code
Summer housing opens on May 8. Please indicate your expected dates of occupancy. Please know that housing charges are not pro-rated. This means you will be charged for an entire month regardless of your actual check-in or check-out date.
Which month(s) will you be requesting Summer housing?*
- May
- June
- July
Please know that housing charges are not pro-rated. This means you will be charged for an entire month regardless of your actual check-in or check-out date.
Check-in Date*
MM slash DD slash YYYY

Date you plan on moving into your Summer housing.
Check-out Date*
MM slash DD slash YYYY

Date you plan on moving out of your Summer housing.
Emergency Contact Name*
First Last
Emergency Contact Phone Number*
Emergency Contact Email*
Enter Email Confirm Email