FOR OFFICIAL USE ONLY

UNIVERSITY OF TECHNOLOGY, JAMAICA

Accept: _________________
STUDENT SERVICES DEPARTMENT
Reject: __________________
ACCOMMODATION OFFICE
Email address: boarding4@utech.edu.jm Waiting List: _____________
Telephone: 970-5262/5191/5841, Fax: 977 – 3305

HALLS OF RESIDENCE APPLICATION FORM

Complete carefully using BLOCK letters ALL sections applicable to you. Incomplete application forms will NOT be
processed. ALL RETURNING RESIDENT AND NON-RESIDENT STUDENTS ARE REQUIRED TO SUBMIT A
COPY OF THEIR PROGRESS REPORT TO THE ACCOMMODATION OFFICE FOR FINAL ACCEPTANCE.

SECTION A: To be completed by all applicants (Please tick () where applicable):

New Student Returning Resident Student Returning Non-Resident Student

Community College Transfer Inter Department/Faculty Transfer Student
Name

Title Surname First Mdl. Inls. UTech's ID No.

Date of Birth (DD/MM/YY) Telephone No. Gender

C( )_________________ H( )__________________

O( )_________________ W( )__________________

Nationality

Email Address (PLEASE PRINT CLEARLY)

Present Address

P.O. Box Street Town Parish Country

Mailing Address (If different from above)

P.O. Box Street Town Parish Country

Person to Contact in Case of Emergency (Next of Kin):

Name: ________________________________________ Relationship: ________________________________
Address: ______________________________________________________Tele: _____________________________

Medical Information:
Do you have any specific medical problem/s? Yes No
If yes please specify: ______________________________________________________________________________
Family Physician: ____________________________________ Contact: _____________________________________
Special Needs:
Physical Challenge Yes No

Please explain ____________________________

Academic Information:
What faculty did you apply to or was accepted for at UTech? _______________________________________________
Which programme did you apply to or was accepted for at UTech? __________________________________________
Year of Study ( 1st, 2nd, 3rd, 4th): _______________________________________________________________________
SECTION B: To be completed by all applicants
Please indicate the period for which you are requesting boarding:
Semester 1 (only) August – December Semester 1 & 2 (August – May)

Semester 2 (only) January – May

Updated, June 2017

(Please note that preference will be given to students requesting boarding for Semester 1 & 2)
Please indicate your Hall preference by placing a tick () in the box below:

Double Occupancy Trip

le
Occ
 upan
cy
Hall F Farquharson
Hall E Hall

Male (Only)
Hall A Garvey Hall
Hall B
Female (Only)
Unisex Dennis Johnson

TO BE COMPLETED BY OWNERS OF MOTOR VEHICLES:

Type: _________________________________________ Model: ____________________________________________
Make: ________________________________________ Registration No.: _____________________________________
FINANCIAL INFORMATION:
Mother’s Occupation: ____________________________Father’s Occupation: _____________________________
Guardian’s Occupation: __________________________________

What is your birth position in the family? ____of ____ No. of dependents under parents’/guardians’ care: _______
Who will finance you for the upcoming academic year? Tick () as many as are relevant to you.
Father Mother Self Other (specify) ____________________
Have you applied for Student Loan: Yes No
Have you requested: Grant Sponsorship both
If yes, please state the organization(s) and the amount:
(1) ________________________________________________________/ $___________________________

(2) ________________________________________________________/ $____________________________

SECTION C: To be completed by all applicants except Returning Resident Students

Please list extra-curricular activities you have been involved in at high school, community college, university and in your community over the last two years

1. __________________________________________ ____ 3. _____________________________________________

2. _______________________________________________ 4. ______________________________________________

Please list your special skills, experiences and abilities

1. ________________________ 2. ___________________________ 3.___________________________ 4. ____________________________

Please list some attributes that best describe you

1. ________________________ 2. ___________________________ 3. __________________________ 4. ____________________________

In not more than five (5) sentences, outline your reasons for boarding on campus apart from location and cost.

SECTION D: To be completed by Returning Resident students only

Hall/Block ___________________________ Years on Dorm _________________ Room Number ____________

List Hall Committee(s) on which you have served:
1.____________________________________ 2._________________________________________ 3. ____________________________

Hall or University Events/activities participated in: ______________________________________________________________________

______________________________________________________________________________________________________________

In the space below, write a short paragraph outlining why you should be readmitted to the Hall.

I hereby certify that the information given above is true and declare that I will comply with the rules and regulations listed in both
the general Student and Resident Student Handbooks.

_______________________________ _______________________________
Updated, June 2017

Signature Date

NOTES
1. Acceptance to the University does not guarantee on-campus accommodation.
2. Only full time students are eligible to apply for on-campus accommodation.
3. It is your responsibility to update your contact information after completing an application form.
4. Persons who have been offered and accepted a place on the Halls of Residence will only be guaranteed
accommodation for a period of one academic year, providing that all rules and regulations are adhered to.
5. Students, who have been assigned on-campus accommodation, please note that fees are payable at any branch
of NCB, Paymaster, Bill Express and UTech Accounts Receivable using a debit card or manager’s cheque.
6. Students who have been accepted to the University, and requested accommodation MUST contact the
Accommodation Office to verify their status.
7. PLEASE CONTACT THE ACCOMMODATION OFFICE TO ENSURE YOUR APPLICATION WAS
RECEIVED.

Updated, June 2017