University Towers

New Residents Spring 2005> Apply Online
A limited number of single rooms are available on a first-come-first-serve basis. Please contact us to find out about availability and cost.

Payment Plan Choices
Installment	Ten installment payments due on the first of each month between 7/1/2004 and 4/1/2005
Semester	Two semester payments due 7/1/2004 and 12/1/2004
Advance	One payment due 7/1/2004. Contact our office for rate.

University Towers Double Room and Dine Any time Spring 2005 Rate Schedule (per person)
Double Room With:	Installment Payment Plan	Semester Payment Plan
Any 7 Meals per week	$727.00 per installment	$3,491.00 per semester
Any 10 Meals per week	$742.00 per installment	$3,564.00 per semester
Any 14 Meals per week	$762.00 per installment	$3,649.00 per semester
Unlimited Meals per week	$792.00 per installment	$3,799.00 per semester
Single Room With: Unlimited Meals per week	$1,125.00 per installment	$5,395.00 per semester

Telecommunications Fee
Spring 2005	One (1) payment of $189 due on 12/1/2004

Personal Information
Social Security #
First Name Middle Last Name
Goes By
Street Address County
City State Zip
Home Telephone #
E-Mail Address
Birthdate Male Female
Current Local Address (if any)
Current Local Phone (if any)
Parents Information
Father's Name
Street Address
City State ZIP
Home Telephone #
Work Telephone#
E-mail Address
Mother's Name
Street Address
City State ZIP
Home Telephone #
Work Telephone#
E-mail Address
University Standing & Preferences
I will be a New Student Continuing Student Transfer Student and a Freshman Sophmore Junior Senior Graduate
What high school/college are you attending or have attended?
I wish to reside in University Towers for
My Dine any Time Meal Plan Choice is
Choose a Payment Plan
Emergency Contact (Other than Parent/Guardian)
Full Name
Telephone #
How did you hear about Universtiy Towers? (check one)
Friend	Family
NC State	HS Counselor
Newspaper	Internet
Magazine	Radio
TV	Other (list here)
Payment Information
Credit Card:
	(3 digit security code on back of card)
Credit Card #	(No spaces or special characters)
Exp. Date	- (2 digit month and 4 digit year) (e.g. 012002)
Name on Card
Billing Address
City
State/Province	Zip/Postal Code
Country

Please Note: The cost to submit this application for new residents is $130 ($20 non-refundable application fee and a $110 service fee refundable up until the signing of the lease agreement). Submitting this application does not assure a room reservation. Space is reserved upon signing of a separate lease agreement by Landlord, Tenant and Guarantor. Local Telephone Service & Internet Access is required of all residents and includes all installation charges, unlimited local telephone calls, private voice mailbox, unlimited internet access and all applicable sales taxes. There is an additional cost for long distance telephone calls. This system will NOT charge your credit card for the amount due. NO CHARGE will be applied to your credit card until we verify this application and availability. Transactions will appear as "University Towers." on your credit card statement. All transactions are secure and all information is kept strictly confidential. Your IP address will be recorded with this transaction. All fraudulent credit card transactions will be thoroughly investigated and prosecuted to the fullest extent of international law.