Summer Residence Application and Agreement First Name Last Name Student ID Cell Phone Number Email Address Room Type Single Room $600/mo Double Room $450/mo Roommate Name Emergency Contact Information First Name Last Name Relationship to you Emergency Contact Phone Number Regulations and Standards The Resident, and/or any person who has been granted permission to enter the Ambrose Residence, shall comply with all rules and regulations pertaining to Ambrose University. Monthly rent payments are due on the first calendar day of the month. Payment by cheque, cash, credit card or debit will be accepted. Payments on campus will be accepted Monday to Friday 9:00 am to 4:00 pm. The Resident will be responsible for the cost of repairs to their room or any common spaces that have been damaged because of the abuse or negligence of the Resident or their guest. The Resident shall not use their room or any of the common spaces for any purpose other than that of a living facility, including any illegal act, trade, or business. The $400.00 Room Reservation Fee (which includes a $25 non-refundable administration fee) will become your Damage Deposit once you move into summer residence. In order to receive a refund, students not planning on living in the residence for the fall semester must notify Campus Services in writing prior to August 25th. Keys for residence must be returned at the conclusion of stay. A fee will be charged for lost or not returned keys. Parking is available and must be requested through Campus Services. A fee may apply for this provision. The use of FasTac brand hooks, Command 3M removable hooks, tacks, nails and/or tape is not permitted on our walls in residence. The Residents may only use “funtac” on the walls in residence. The Resident will not bring into their room a pet of any kind. The Resident shall keep all common areas, including hallways and stairwells, free from boxes, bicycles, sports equipment, laundry and other personal belongings, due to cleaning and fire escape requirements. Open flames, including candles, are not permitted in the residence, due to fire and safety regulations. False fire alarms will result in a fee from the City Fire Department and will be the responsibility of the Resident(s) involved. The distribution, possession and/or consumption of alcohol, tobacco, and/or drugs in residence is strictly prohibited. Firearms, firecrackers, paintballs, airsoft and other materials or equipment that may be dangerous to others or self are not permitted in the residence or other public areas of the campus. The emergency exit door located at the end of each pod’s common area is not to be propped open. The playing of amplified instruments is not permitted in the residence building. Residents are expected to refrain from the following practices, including but not limited to, drunkenness and other forms of substance abuse, the use of profane language, all forms of dishonesty, cheating, or misrepresentation, involvement in the occult, gambling, the use of pornography, any form of interpersonal sexual activity outside of marriage, and all criminal activity. Harassment to staff or residents will not be tolerated. Quiet outside the residence is in effect from 10:00pm – 7:00am, in accordance with city bylaws and out of respect for the greater community surrounding our campus. Residents are responsible to respect other residents’ rights to privacy, sleep, and quiet. Excessive noise any time of day is not acceptable. Likewise, residents are to respect others’ property. Other’s possessions should not be utilized without permission. Ambrose shall not be liable for damage to person or property or loss of property for any cause whatsoever, whether the same be caused by default or negligence of another Resident, or any person, whether lawfully or unlawfully upon the premises, and the Resident shall indemnify Ambrose against any such claim out of or in any way related to the actions of the Resident. Any non-observance or non-performance of the Ambrose Summer Residence Standards could result in the resident being removed from the University campus. By choosing to follow these standards, we mutually agree that safety and belonging take precedence in this community. Declaration I have read and agree to commit myself to upholding the Residence Standards of Ambrose University for the full duration of my stay in the residence. Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201720182019 Ambrose University is committed to safeguarding the personal information entrusted to us. We manage your personal information in accordance with Alberta’s Personal Information Protection Act and other applicable laws. Information collected in this form may be used to contact you regarding programs and services. It will form part of your record as an applicant, student, and alumnus and may be disclosed to academic and administrative units. All information is considered confidential and will be used and disclosed in accordance with privacy legislation. For more information regarding the collection or use of this information, please contact the Privacy Compliance Officer (403-410-2000 or e-mail firstname.lastname@example.org).