Wright State University
Guest Housing Pre-Registration

Name

Address

City, State, Zip

Country (if applicable)

Home Telephone # Cell Telephone #

E-Mail Address

Vehicle Make   Model   Plate #/State

Gender

Male   Female

Are there any additional people planning to stay with you?

# of Adults

# of Children

Names of Adults

Names of Children

Ages of Children

Visiting Researcher

Yes   No

Sponsoring Department

Campus Contact Person

Contact Phone #

Verification: (For office use only)

Are you responsible for the housing payment?

Yes   No

If no, who is responsible for the housing payment?

Please indicate the dates that you require housing (Office hours are 8:30am - 5:00pm M-F ONLY)

Check-In Date     Anticipated Time of Arrival

Check-Out Date     Anticipated Time of Departure

Rates may be subject to change. Call ahead of rate updates.

*Weekly/monthly rates include: local phone service, basic cable TV service, utilities, parking pass, an internet account (must provide ID) and a basic linen set. Extra towels and linen are located in the unit.

Weekly Rate (7-night stay)

Single Occupancy Apartment - $350 per person per week
Double Occupancy Apartment - $220 per person per week
Quad Occupancy Apartment - $150 per person per week

Any other comments/requests?

GUESTS ARE RESPONSIBLE FOR ANY REPAIR OR CLEANING CHARGES UPON CHECKING IN.

(For university use only)

Fund   Org   Acct   Program