Residence Hall Application Form Residence Hall Application Name* First Middle Last Preferred NameGender*MaleFemaleDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Email* I plan to start MCC courses in the...*FallSpringPerson to be notified in case of accident or illness.*(Name, Relationship, Phone)High School Graduation Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920My current (or high school) GPA(Approximate)Incoming College Academic Classification*First-Year FreshmanTransferOtherIntended Program of Study*ChildrenCounselingFamilyIntercultural StudiesPastoralSpiritual FormationTheologyWorshipYouthDual Degree with Kansas State UniversityDual Degree with Manhattan Area Technical CollegeUndecidedThe approximate population of my hometown/rural areaHometown ChurchChurch Denomination*Assemblies of GodBaptistCatholicChristian ChurchDisciples of ChristLutheranMethodistNon-DenominationalPresbyterianOtherBrefly describe your church involvement*I would prefer a roommate who would keep the room neat and clean*YesNoNot importantI like to stay up late at night (past midnight)*YesNoI usually get up early in the morning (before 8:00 am)*YesNoHow do you consider yourself?*IntrovertExtrovertSomewhere in betweenList three hobbies you enjoyPlease list physical conditions which would require considerationUntitledPlease give details of any physical, mental or emotional problem(s) you have had in the last five yearsPlease list any medications you are currently takingIf available, would you like to be in a quiet, study-intensive suite/floor?YesNoOther specifics you would like us to consider in matching you with a roommateRoommate Choice(s)If you already have someone you would like to be your roommate, please list them here. Be sure to have the person you list also list you on their application.CAPTCHA