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We at Residence Hall care about your privacy. The information we collect in this form will only be used for the purpose of processing your application and it will not be shared with a third party. All data collected is transmitted securely to our server and is encrypted using 256-bit SSL technology.

This application is good for all type rooms. If approved, based on availability, you will be able to choose the type of room you want at the time of signing the license agreement.

Required fields are marked with an asterisk ( * )

How did you hear about us? Promotional Code:
Applicant Information
Gender: * Male Female Expected Move-In: *
First Name: * International student? (social security # is NOT required for International Students)
Middle Initial: Social Security # *
Social security info is secure and encrypted
Last Name: * Date of Birth: *   mm/dd/yy
Permanent Home Address
Home Address: * Home Phone: *
  Alt. Phone:
City: * Primary E-Mail Address: *
State/Province: * Secondary E-Mail Address:
Postal Code: *  
Country: *  
School & Housing Information
Expected Major:
[ Academic and Annual Pricing ]
Academic Year License (Aug-May, 9.5 Months)
Annual License (Aug-Aug, 11.5 Months)
1 Semester Only

Summer License
Status Upon Move-In:
Terms & Conditions

I, the Applicant, represent that all of the above information has been provided by me and is true and complete. I understand that any misrepresentation made in the Application may be cause for the rejection of this Application and/or the termination of the License Agreement. Applicant further authorizes the exchange of information between Brooklyn College and other City University of New York institutions and RHBC Management, relating to the applicant's student status, academic records, judicial records, and financial records to be used to determine whether this application shall be approved or disapproved.

Completion of this Application does not guarantee the Applicant a space in Residence Hall.

*  I, the Undersigned Applicant, have read and agree to all terms and conditions set forth in this application.

Applicant Signature: * (print your name)
Please type in the verification code in the box below.

Residence Hall @ Brooklyn College

1 Kenilworth Place, Brooklyn, NY 11210
Tel: 718-252-5000, Fax: 718-252-5553 E-mail:
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