DA Application

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HOUSING AND RESIDENTIAL LIFE

First Name:

Last Name:

MTSU Email:

(user@mtmail.mtsu.edu)

Phone Number:

Date of Birth:

Gender:

M Number:

Date of Application

Current Local Address:

Residence Hall/Room # or Street / City / Zip Code

Home/Permanent Address:

Street / City / Zip Code

Spring Term

Summer Term

Fall Term

Including this semester, how many semesters have you lived in a residence hall?

Do you currently reside in a residence hall?

Hall preference for employment: 1)

What shifts can you work?

Early Morning (2am - 7am)

Morning (7am - noon)

Afternoon (noon - 5pm)

Evening (5pm - 10pm)

Overnight (10pm-2am)

Major(s):

Anticipated Graduation Date:

Classification:

Semester GPA (A 2.5 GPA is required at time of application):

Cumulative GPA (A 2.5 GPA is required at time of application):

Have you attended another college/university besides MTSU?

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