Hendrick House

ROOMS ARE AVAILABLE ON A FIRST COME, FIRST SERVE BASIS. Once your application is submitted, we will send you a contract. The student and parent must sign the contract and return it to our office with a check for $300. Contracts are confirmed in the order in which they are received in our office. Space is limited. If you have any questions, please call our office 9am-5:30pm, Mon-Friday or email:office@hendrickhouse.com. Thank You!

STUDENT INFORMATION

Today's Date

MMDDYYYY

University ID Number (UIN) required

Your UIN is the nine-digit student ID will typically begin with the number 6.

UIUC NetID required

Your NetID is the part of your UIUC email address that comes before @illinois.edu

Name

FirstMiddleLastSuffix

Gender

Date of Birth required

MMDDYYYY

Application Term required

Contract Type required

Please click next to provide us your address and contact information,

STUDENT & PARENT CONTACT INFORMATION

Home Mailing Address

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Student Email Address required

Student Cell Phone Number

Free HH T-Shirt Size

Parent Name required

FirstLast

Relationship to Student

Parent Email Address

Payment Reminders for Parents

YES! I would like to receive email reminders about upcoming contract payments.

NO! I would not like to receive email reminders about upcoming contract payments.

Parent Home Address required

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

House Phone Number required

Office Phone Number required

Parent Cell Phone Number

Please click next to tell us about your academic standing.

ACADEMIC INFORMATION

Your academic information is used in the roommate assignment process, and provides us with important building demographics. Please tell us about your academic background.

Your Year in School for 2013-2014 required

Institution required

College

Major

Minor

High School

Class Rank

Please click Next to tell us about your payment and financial aid status.

PAYMENT & FINANCIAL AID

All information is held in strict confidence.

Parent Occupation required

Parent Company required

Company Address

Work Phone Number

Please indicate your source of income for college expenses.

% Financial Aid required

% Family Contribution required

% Other - Please Describe required

Please click NEXT to tell us about your health & emergency information.

HEALTH & EMERGENCY INFORMATION

Emergency Contact required

FirstLast

Emergency Phone Number required

Emergency Medical Conditions

Medications

Allergies

Please list any conditions that require special food.

Special Food Needs

Please click NEXT to tell us about your roommate preferences.

ROOM & ROOMMATE INFORMATION

The following questions will help us when preparing roommate and room assignments. We use your preferences toward the goal of finding a compatible room assignment for each student. Preferences are not guaranteed but we strive to find the best placement for you within our community.

If you know who you would like to live with and a room that you prefer, please let us know here.

Floor Preference

Room Preference

Roommate Preference

Suitemate Preference

If you do not know who you would like to live with, please give us as much information as possible about yourself.

I prefer that my room is:

I like to study in my room:

I like online gaming:

I Like to stay up past midnight:

I like to get up early:

I like having friends over:

I prefer a:

Non-Smoker

Smoker

This is a good place to add details. Why kind of music do you like? Do you like a cold room or a warm room? Do you prefer to be on a specific floor or area of the building?

Tell us about yoursef

Hobbies

Activities & Organizations

Is there something we missed? Please give us any final details that will help to find you a roommate.

Additional Information

You are nearly done! Please click next to continue.

WRAP UP & ADDITIONAL AMENITIES

Parking

I don't need parking

I need a motorcycle parking space ($240 per year)

I need a car parking space ($480 per year)

Bike Room Access

I don't need bike room access

I need bike room access ($80 per year)

Linen Service

I don't need to rent bed linens

I need to rent bed linens ($50 per year)

I heard about Hendrick House from:

I am a returning resident

New Freshman Materials/PCH Brochure

A Resource Fair

The Daily Illini/WPGU

Other Advertsing (please specify below)

Personal Referral (please give us the referrer's name below)

Additional Referral Info

Please click submit to finish your application. A housing contract will be emailed via your student's email account once the application has been processed.

New Student Application

Housing Application