Short Stay Residence Application

Short Stay Residence Application

Your residency is not complete without the Welcoming Waivers Package. (Check your email.)
Today's Date

MonthDayYear
Date
Name

First NameLast Name
Pronouns
Preferred name to be called
Purpose of my visit
Affiliation to AST
Program of Study (if applicable)
Year of study (if applicable)
Residence Start Date

MonthDayYear
Date
Residence End Date

MonthDayYear
Date
To verify your ongoing enrollment without registrar fees, please upload one of these free options from your student portal: a screenshot clearly displays your name, school name/logo, current term dates, enrolled courses, and enrollment status (e.g., full-time) Options: - Student Portal screenshot - Unofficial Transcript - Term account summary or payment receipt During your residence stay, you may be required to periodically submit an updated letter via email to verify your active student status and ongoing enrollment. You may be asked to provide a Confirmation of Enrollment Letter. Students pay for any Registrar's Office charges. (if applicable)

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Permanent Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YOUR PERSONAL INFORMATION
(International students are required to have a local mobile # and notify the Residence manager as soon as it’s received.)
Phone Number
Your best phone # for AST to communicate with youFormat: (000) 000-0000.
Email
Your best email for AST to communicate with you.
Date of Birth

MonthDayYear
Date
SOME THINGS I THINK YOU SHOULD KNOW ABOUT ME (special needs, health-care status, allergies, etc.)
EMERGENCY CONTACT INFORMATION
Name
Relationship to you
Phone number
Email Address
Please process my payment of $50/night and the cleaning fee of $50 to the credit card indicated
1st Floor Room2nd Floor Room3rd Floor Room
Close to female washroomClose to male washroom
STUDENT SEXUAL VIOLENCE AWARENESS PREVENTION PROGRAM (if applicable)

AST, together with other universities in Nova Scotia, participates in a program to educate students about sexual violence awareness. Each new resident is required to attend SVP training shortly after arrival. Sessions are typically offered in September/October (for students arriving in the Fall semester), January/February (for students arriving in the Winter semester), and June (for students arriving in the summer semester)

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CREDIT CARD INFORMATION

Credit card information will be requested in the Welcome Waivers Package.
Yes, $233 (May through August)No
Type of Vehicle (i.e.: car, truck, motorcycle)
Vehicle Make and ModelExterior Colour
Driver's LicensceCanadian Province
I understand that if my application is accepted, my daily room rate and my agreement with AST will be in effect for the entire period noted on this form. I understand that should I decide to leave before the end of that period, I will be responsible for payment of the full rent period. I have read the AST Residence Policy Document, Resident Handbook, and AST Sexual Violence Policy on the AST website and agree to abide by any standards and regulations specified there.
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Date Time Location
Your residency is not complete without the Welcome Waivers Package.
(Check your email.)
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