University of Virginia Library

DORMITORY APPLICATION

Secretary of Summer Quarter,

Box 1337, University of Virginia,

University, Virginia.

Sir:

I hereby apply for a room or suite in the dormitories for the coming session,
and inclose $1.00 for each person to cover the required deposit. The following
rooms or suites are listed in order of preference, and if none of those specifically
applied for are available, assignment may be made from rooms or suites similar
in price and location.

1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________

5. ___________________________________________________________________________

(Students expecting to attend both terms should make reservation in Venable, Harrison,
Tucker, Holmes, Rogers, or Peters Hall. Other Halls will be closed
Second Term. Davis Hall will be open for men both terms.)

I wish to make application for Board at the Commons. Yes. No.

(Students desiring to co-operate in securing the minimum rate of $32.75 for the
term of six weeks should sign up promptly.)

I will attend First Term —. Second Term —.

I am a graduate student —; under-graduate student —.

Church preference —.

I wish to occupy suite alone —.

Name of roommate __________________________________________________________

(Roommate should send check for $1.00 also)

Address _____________________________________________________________________

(If the above information is not reported on this application the Secretary will
assign a roommate to fill the vacancy.)

Signed ______________________________________________________________________

Street _______________________________________________________________________

City ______________________________________________ State_____________________

(Check should be made payable to University of Virginia and mailed to the
Secretary of the Summer Quarter.)

(Each student must have a receipt for the full payment of room rent in order
to secure his or her room key.)