Housing Application

No Housing applications will be considered without first applying for admission and being accepted into an academic program at Iowa Lakes Community College.

This application does not guarantee an On-Campus Housing Lease, but will allow you to be placed on our waiting list. Returning Sophomores will be given first priority.

There is no guarantee of roommate preference. You do have the option below to list a preference. Roommates will be assigned in early August.

Iowa Lakes Community College has the right to refuse housing.
(Iowa Code 692A.2A states no sex offender may reside within 2000 feet of a child care facility or a public or nonpublic elementary or secondary school)

Student Status*

FreshmanSophomore

Applying for semester beginning*

FallSpringSummer

Year*

Academic Program*

Advisor's Name (if known)

Sex*

MaleFemale

Campus*

EmmetsburgEsthervilleSpencer

Dorm Preference (Estherville) *

	First Choice	Second Choice	Third Choice
Laker I
Laker II
4-Plex/6-Plex

Dorm Preference (Emmetsburg)*

	First Choice	Second Choice	Third Choice
Ballaster
Catamaran
Spinnaker

Name*

First NameMiddle InitialLast Name

Birth Date*

MonthDayYear

Email*

Please use a personal account, not a high school account

Cell Phone Number*

Area CodePhone Number

Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Name(s)- If Applicable

Parent/Guardian Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Email

example@example.com

Parent/Guardian Cell Phone Number

Area CodePhone Number

Parent/Guardian Home Phone

Area CodePhone Number

Parent/Guardian Work Phone

Area CodePhone Number

Do you have any special needs to be considered?

No, I do not have any special needs to be considered.Yes, I do have special needs to be considered.

If yes for special needs, please describe

If known, roommate preference by name

Traits about yourself for roommate compatibility options

Convicted Felon*

NoYes

Sex Offender*

NoYes

Non-Discrimination / Equal Opportunity Statement

Iowa Lakes Community College offers career and technical programs in the following areas of study:

Agriculture, Natural & Environmental Services
Engineering and Construction
Arts, Design, and Visual Communications
Business, Management, and Marketing
Education, Public, and Human Services
Health Science
Hospitality
Information Technology
Manufacturing
Transportation & Logistics

It is the policy of Iowa Lakes Community College not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, creed, religion, and actual or potential family, parental or marital status. If you have questions or complaints related to compliance with this policy, please contact a title IX coordinator for Iowa Lakes Community College, Administration Building, 19 South Seventh Street, Estherville, IA 51334, telephone: 712-362-0430, equity@iowalakes.edu or Director of the Office for Civil Rights, U.S. Department of Education, Cesar E. Chavez Memorial Building, 1244 Speer Boulevard, Suite 310, Denver, CO 80204-3582, Telephone: (303) 844-5695 FAX: (303) 844-4303, TDD 800-877-8339 Email: OCR.Denver@ed.gov.

A formal discrimination complaint process is published in the Student Handbook, Employee Handbook, and the Affirmative Action Plan of the College.

Signature*

Date*

Date