Forms Manager

MN Head Start Housing

ONLY ONE PERSON FROM THE GROUP STAYING NEEDS TO FILL OUT THE HOUSING REGISTRATION FORM.

Last Name

First Name

Sex

	Male
	Female

Street Address Line 1

Street Address Line 2

City

State

Zip Code

Phone Number

Email Address

PLEASE CHOOSE YOUR APPROPRIATE ARRIVAL DATE FROM THE DROP DOWN OPTIONS LISTED BELOW.

Arrival Date

PLEASE CHOOSE YOUR APPROPRIATE DEPARTURE DATE FROM THE DROP DOWN OPTIONS LISTED BELOW.

Departure Date

All Residence Hall rooms have a sink in the room. The following items are included in all housing accomodations: Sheets, Blanket, Pillow, Bath Towel, Washcloth, Soap, and Plastic Cup.

Apartments: Accommodate 4 people. The apartments have 2 bedrooms with 2 single beds in each room. All apartments have restrooms and showers within the apartment as well as a kitchen, washer and dryer, and living room. Kitchens have a refrigerator/freezer, stove and oven, however, are not stocked with utencils, dishes, etc.

Housing Rates Listed Include 7.625% Sales Tax and 3% City Lodging Tax

Housing Options (Price Is Per Night and Includes Tax)

	Single Residence Hall Room with Air Conditioning (Bathrooms Down The Hall)	$49.78
	Double Residence Hall Room with Air Conditioning (Bathrooms Down The Hall)	$64.16
	4 Person Apartment	$161.51

Please list your roommate(s) name(s) if applicable. Roommates will not be assigned so please select a single room if you do not have a roommate.

Roommate 1: (Last Name, First Name)

Roommate 2: (Last Name, First Name)

Roommate 3: (Last Name, First Name)

Special Requests/Needs:

A confirmation of your housing request will be emailed to you within 24 hours. In the event that you do not receive a confirmation please contact the Events and Conferences Department at (320) 363-6367.