Spring Housing Request Form

The following form is only to be filled out by students studying abroad in the fall semester. Forms will not be accepted from students not studying abroad.

If you are interested in living on campus in spring 2014, you must submit this form to request housing by Oct. 31, 2013. Completing this form does not guarantee you will receive an on-campus housing assignment.

If one of your choices is to be pulled into a double, a suite, or an apartment, a Mid-Year Pull-In Request needs to be submitted in addition to this form.  Please see the Mid-Year Pull-In Request for specific dates and details.

Please fill in all fields on the form. Incomplete applications may not be accepted. You will be notified of your housing assignment via email by early December. If you have any questions, please feel free to email us at dcl@brandeis.edu or call us at 781-736-5060.

Fields marked with * are required. Forms with incomplete information will not be processed.

*First Name:

*Last Name:

*Brandeis Email Address:

*Sage ID #:

*Class Standing (as of spring 2014):

*Permanent Address:

*Home Phone Number:

Cell Phone or Other Phone Number:

Preferences: Enter your top three housing choices. Please include specific suites/rooms/locations if applicable. While Community Living will work to assign you to housing that meets one of your preferences, there is no guarantee we can accommodate all requests.

*Preference 1:
*Preference 2:
*Preference 3:

Additional Information: If there are friends you would like to live with who are currently abroad, or if there is anything else you think is important to let us know about your preferences, please include it below.


Yes, I want to be pulled-in and I will be submitting a Mid-Year Pull-In Request form.

No, I do not want to be pulled in and I will not be submitting a Mid-Year Pull-In Request form.

I'm not sure. I have not decided if I want to be pulled-in and if I will be submitting a Mid-Year Pull-In Request form.