Capitol Technology University Student ID#
Legal First Name:
Legal Last Name:
Date of Birth:
Student Email Address:
(Copy of application will be sent to this address upon successful submission)
My Current Address is the same as Permanent Address (above):
I am seeking housing for:
First Preference Housing Type:
Second Preference Bedroom Type:
If your preference is for a single which single setup would you prefer?
(You can choose more than one, and please remember that there is a price difference between the singles for the 2022-2023 academic year. See license for more details.) If you have a ranked order of preference for a single room type please email that to email@example.com directly following application submission
Name(s) of preferred roommates, if any:
Name(s) of preferred apartment-mates, if any:
Which is more important:
I plan to study mostly:
I study best with:
I mainly plan to use the common space for...
I like living in a...
Do you smoke?
(All apartments are nonsmoking)
Do you mind sharing a room with someone who smokes:
Typically, what time do you go to bed?
Do you intend to have a car on campus:
I plan on going home...
Please select your top 3-5 concerns about living with future roommates/apartmentmates
Do you have any physical disabilities, accommodations, and or other needs that should be considered when assigning you a room?
If yes, please specify:
Do you have health insurance?
If yes, name of health insurance:
If yes, policy number:
Effective June 1, 2000, Maryland law requires that an individual enrolled in an institution of higher education in Maryland who resides in on-campus student housing must be vaccinated against meningococcal disease. An individual may be exempt from this requirement if (1) the institution of higher education provides the individual or the individual’s parent or guardian (if the individual is a minor) detailed information on the risks associated with meningococcal disease and the availability and effectiveness of any vaccine, and (2) the individual or a minor individual’s parent or guardian signs a waiver stating the individual or the parent or guardian has received and reviewed the information provided and has chosen that the individual will not be vaccinated against meningococcal disease.
This is the form you must fill out if you plan to live on campus. It is both the acknowledgement that you've received the vaccine and the waiver. If you've received the vaccine, make sure it is on your vaccination records.
Please upload completed Meningitis Form here.
Capitol Technology University Department of Residence Life requests the following information from residence hall students. There is not a medical facility on the campus; however, this information serves as a document that can be shared with health officials in case of an emergency. You may either upload the document here OR you may mail it to Capitol Technology University C/O Residence Life OR you may email it to firstname.lastname@example.org.
Upload Immunization Record (optional)
In accordance with the Family Education Rights and Privacy Act of 1974, it is Capitol Technology University's policy not to release any personal information about students. Your apartment and room number will not be released to persons attempting to locate you without your permission.
Please indicate as follows:
I acknowledge that my email address will be shared with my immediate roommate/apartmentmates to ensure communication prior to move-in. Only the email of the student will be shared.
Emergency Contact #1
Relation to Student:
Emergency Contact #2
Academic Year (Fall 2023-Spring 2024)
Click on file to download, review, initial and sign the 2023-24 Housing License)
51 week Application and License:
(Click on file to download, review, initial and sign the 2022-23 51 week application and license)
Only attach one license. Applications are not complete with an UPLOADED, INITIALED and SIGNED license.
(only if student is under 18 years of age)