All information with a red label is required.

Applicant Information

Permanent Home Address

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Emergency Contact Information

Reservation Information

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Rooming Requests

Do you have any ADA or other accommodation requests?

Roommate Request 1
Roommate Request 2
Roommate Request 3
Name of Internship Company
Internship Address
City   State   Zip  
Internship Contact Name
Internship Contact Phone
If possible, I would like to be assigned to the following apartment type:

Terms and Conditions

Applicant understands that to secure use of a bedroom within an apartment, he/she must complete all Lease Agreement paperwork and pay all fees. Applicant understands that if, at any time, there are un-Leased bedrooms in the applicant's assigned apartment, Capstone On Campus Management (COCM), as Agent for PRC Campus Centers LLC, reserves the right to assign roommates without prior notice and/or relocate the applicant to another unit. Applicant further understands that roommate compatibility is NOT guaranteed.

Applicant represents that all of the above information is true and complete and authorizes the verification of same by reasonable means. Any misrepresentation or omission may be cause for the rejection of this application and/or the termination of the Lease Agreement. Applicant further authorizes free exchange of information between The College of New Jersey and COCM, including but not limited to the applicant's student status, academic records, judicial records, and financial records.

Applicant understands that a financially-responsible Guarantor (over the age of 21) is mandatory for the completion of the Lease Agreement process, and failure or refusal to provide a Guarantor may result in the cancellation of this application and any resultant Lease Agreement.

I, the Undersigned Applicant, have read and agree to all terms and conditions set forth in this application. I understand that this application is part of my lease, especially those areas regarding earnest monies.

Database Info:  PRCCTEA_141369  CAP_CTEA