Applying to University Place is Fast & Easy!
Fill out the application form completely including your credit card information Press the "Submit" button
to securely submit your application or print the application and mail or fax it to us at:

NY Student Housing, LLC
885 Second Avenue, Suite 3400
New York, NY 10017
Fax: 212-732-0300

Confirmation of your reservations will be sent via e-mail within 3 business days.

Reservations are based on availability and are subject to change without notice. Your space is only guaranteed once you electronically sign a license agreement and receive a reservation confirmation.

Reservations are based on availability and are subject to change without notice. Your space is only
guaranteed once you sign a license agreement and receive your confirmation. At the time of confirmation,
your credit card will be charged the total reservation fee.

Student Application

This form should be filled out by, or on behalf of, the student using their information and relevant details.
Billing information will be requested on the next screen, after the application has been submitted.

Student First Name:

Student Middle Name:

Student Last Name:

Date of Birth:

Gender: Male Female

Are you a US citizen: Yes No

How did you hear about University Place?

What school or program are you currently attending?

Are you going to be a student or an intern?

If you are going to be an intern, which organization will you be working for?

Permanent Address

Street:

Apt #:

City:

State/Province:

Postal Code:

Country:

Home phone:

Cell phone:

Email address:

Criminal Record

Have you ever been convicted of a crime? Yes No

If yes, please explain:

Emergency Contact

Name:

Phone Number:

Street:

Apartment:

City:

State:

Zip:

Country:

Relationship to Student:

Housing Information

Semester you are applying for housing:

Please choose your first and second choice room design:

First choice:

Second choice:

Click here to review room options

Roommate Matching

Unless you request a specific roommate, we will do our best to make the perfect match.

Tell us about yourself:

High School:

Hometown:

What major are you pursuing:

Are you an early riser? Yes No

Are you a late night person? Yes No

Social life: Very outgoing, like to go out and socialize Enjoy socializing on weekends Enjoy the quiet life

Do you consider yourself: Neat Fairly neat Comfortably cluttered Sloppy

Are you a smoker? Yes No

Do you have any special needs:

I have read and agreed to both the website user agreement and privacy policy.

Please type your initials below to indicate you have read, understood and accept the terms and payment schedule of the license agreement:

Initials: