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
Share with your friends: |