SUNY Niagara Housing Application

"*" indicates required fields

Full Name*
Address*
A receipt will be sent to your T-Wolves e-mail address you provide
MM slash DD slash YYYY
Date

Emergency Contact

Emergency Contact Name*

Academic Information

Roommate Matching Information

Parking space needed?*
Disabled/Medical Accessibility:*
Dismissed from another college?*

Roommate Request

Roommate Name 1
Roommate Name 2
Roommate Name 3

Listed roommates must request and agree to assignment.

Payment Method*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa