Big Bend Community College
Residence Halls Application & Contract
20____ – 20 ____
Please return to the Business Office at 7662 Chanute Street NE, Moses Lake, WA 98837. Application with a $200.00 deposit must
be returned at least 15 days prior to occupancy or room will not be held. No reservation will be considered without the
Please answer all questions, printing clearly
Name BBCC Student ID #
LAST FIRST M.I.
Permanent Address Phone # ( )
Cell Phone # ( )
CITY STATE ZIP CODE
Sex _____ Age _____ Birth Date ____________ E-mail Address _____________________________ Major
Person to notify in an emergency Relationship
Address Phone #
Cell Phone #
CITY STATE ZIP CODE
Do you expect to bring a vehicle? Yes No Make & Model Color License #
Americans With Disabilities Act Requests. If you have any medical or physical condition(s) which requires special
accommodations, please list. This information is voluntary and will be used only to assist in making the most appropriate housing
assignment for you, and to enable the Residence Halls staff to better assist you should an emergency arise.
Check class status in college when occupancy is to begin: Freshman Sophomore Third Year
Check quarter occupancy is to begin: Fall 20____ Winter 20____ Spring 20____ Summer 20____
Rooms are assigned on a double occupancy basis. Single occupancy rooms may occasionally be available. If you request and are
assigned a single occupancy room a quarterly surcharge of $180 will apply. All room assignments are at the discretion of the
Residence Hall Director.
Have you ever been convicted of a crime?* Yes No
*An affirmative answer to this question will not automatically preclude on-campus housing. If you answered Yes, you must submit a full statement
of relevant facts on a separate sheet attached to this form. Include all relevant dates and a signature on the statement. You may be required to furnish
copies of all official documentation explaining the final disposition of the proceedings.
SIGNATURE OF AGREEMENT
I acknowledge that I have read, understand and agree to the terms and conditions of occupancy of the Residence Hall Contract
outlined on the reverse side of this form and agree that, if accepted, I will abide by and be legally bound to these terms and conditions.
Violations of these policies may result in disciplinary action up to and including eviction from the residence halls.
(PARENT / GUARDIAN SIGNATURE IF APPLICANT IS UNDER 18 YEARS OF AGE)
BBC 33-1 (6/06)
Big Bend Community College
Residence Halls Contract Terms and Conditions
1. Upon submitting proper notice to the Residence Hall and/or room charges through the Residence Hall
Manager, a resident may leave the hall between Manager, and following the appeals process
quarters. A student leaving the residence hall during detailed in the Student Handbook.
the quarter without withdrawing from the college will
9. Except for normal wear and tear, each student is
forfeit their deposit and any unused portion of their
responsible for his/her damage to the building, furniture
and equipment. The college reserves the right of entry
2. A $200.00 room and damage deposit must accompany to inspect student rooms, furniture, equipment, to make
this application. This fee is refundable after the student any necessary repairs and to remove fire, safety or
vacates the residence halls, subject to deductions for health hazards.
individual or community damages sustained by the
10. Residents must be admitted students in good standing,
college. Individual damages will be billed directly to
currently registered for a minimum 10 credits.
the student and are due upon receipt of the bill.
11. All residents are to register overnight guests and have
3. In addition to the $200.00 room and damage deposit,
prior approval from the Residence Hall Manager.
the minimum amount due at check-in shall be one
third of the total cost of housing for the relevant 12. The following are not permitted in the Residence Halls:
academic quarter, with the remainder being due in two a. The use or possession of alcoholic beverages or
equal payments at intervals of one calendar month from controlled substance or their containers
date of occupancy. Payments due on a Saturday will be b. Gambling
payable on the previous Friday. Payments due on a c. Smoking or use of smokeless tobacco
Sunday will be payable on the following Monday. Rent d. Firearms, air guns, paint guns or any type of
not paid within two days of the payment due date will explosives, including firecrackers
incur a $5.00 per day late fee. Payments may also be e. Engines, gas, oil, paint or solvents
made in full prior to occupancy. Payment options are f. Pets
cash, check, debit, Visa, Master and Discover cards. g. Stolen property
All payments must be made to the Cashier’s Office.
13. Residents are also subject to additional regulations,
4. For students moving in after the end of the fall quarter, policies and standards outlined in the Residence Hall
the terms and conditions other than the schedule of Handbook and those adopted by the residence hall
payments will remain the same. student organizations. Failure to comply with these
regulations may be grounds for financial penalties,
5. Before the applicant takes occupancy, all or part of the
dismissal from the residence halls and further
$200.00 room and damage deposit is refundable under
the following conditions:
a. If the college refuses admission to the applicant 14. Big Bend Community College assumes no
b. If the application and contract is canceled not responsibility for loss or damage to a resident’s
later than 7 days prior to the opening of the hall personal property. Students should consider purchase
of insurance to cover the loss or damage of personal
6. Reservations not claimed by noon of the first day of
property or the extension of parent’s insurance for this
instruction will be terminated by the college. In such
event, the $200.00 room and damage deposit will not be
refunded. 15. Students may not use their rooms or any of the building
facilities for commercial or illegal purposes, soliciting
7. After the applicant takes occupancy, the unused portion
or distribution of published materials. Fund raising in
of the $200.00 room and damage deposit is refundable
the residence halls may only be conducted in
under the following conditions:
accordance with college policy and with the approval of
a. If a regularly enrolled student withdraws or
the Residence Hall Manager.
graduates from the college and presents written
evidence of withdrawal or graduation 16. The college reserves the right to reassign residents in
b. If a student follows the Residence Hall order to make the most effective use of available
Handbook checkout procedures accommodations.
8. If a student leaves the residence halls during an 17. The college reserves the right to make all room
academic quarter for disciplinary reasons or leaves the assignments for students living in the residence halls.
residence halls and does not withdraw from the college,
the following policy will apply:
a. Residents will forfeit all unused portions of rent
b. Residents will forfeit all room damage deposits.
Residents may appeal non-refund of deposit