Gammon theological seminary



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GAMMON THEOLOGICAL SEMINARY

Office of the President-Dean

653 Beckwith Street, S.W.

Atlanta, Georgia 30314

Phone: 404-581-0300

Fax: 404-581-0305
HOUSING APPLICATION FORM

(Please Print Clearly)



2 Identifications Needed: 1) Student ID, and 2) Driver’s License or State Photo ID
Date: _________________

Name: _____________________________________________________________________________ ________ ___ Male ___ Female

Last Name First Name Middle Initial
Current Address: __________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________

City State Zip Code


Telephone Numbers: Home__________________________________________ Cell ___________________________________________
Work __________________________________________ Email Address __________________________________________

Seminary Affiliation (please check one):

___ Gammon ___ Turner ___ Phillips ___ Baptist ___ C.H. Mason ___ J.C.Smith ___ Richardson

Undergraduate Affiliation (please check one):

___ Clark/Atlanta ___ Morehouse ___ Spelman

Housing Request: (please choose one option, per category) ___ Fall 20_____ ___ Spring 20_____ ___ Summer 20_____

___ Gammon Hall (Dormitory – Seminarians and Undergraduates)

___ Dorm Room/Shared Bath ___ Dorm Room/Private Bath (small) ___ Dorm Room/Private Bath (large)

Requesting Housing As (please check one): ___ Single Student ___ Married Student

Handicapped Student: ___ Yes ___No; Interested in sharing dorm room: ___ Yes ___No

Spouse’s Name (if applicable): _______________________________________________________________________________________________
In Case of Emergency, Contact:
Name: _______________________________________________________________ Relationship: ___________________________________
Address: _________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________

City State Zip Code


Telephone Numbers: Home _________________________________________ Cell ___________________________________________
Work __________________________________________ Email Address __________________________________________

I acknowledge that the above information is correct to the best of my knowledge.


Signature of Applicant: _______________________________________________________________________ Date: ________________________

It is the policy of Gammon Theological Seminary not to discriminate on the basis of race, color, national/ethnic origin, sexual orientation or disability in its housing policies. However, as a constituent member of the Interdenominational Theological Center, Gammon Theological Seminary (a United Methodist seminary) reserves the right to offer housing first to United Methodist seminary students.
P
OFFICE USE ONLY:
Date Received ________________
Date Approved _______________
Housing Unit Assigned:

__________ Gammon Hall

__________ Willis J King
lease Return To:

Office of the President-Dean

Attn: Rev. Sandy Hall, Special Assistant

Gammon Theological Seminary



653 Beckwith Street, SW

Atlanta, GA 30314

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