Adelphi Residential Life Program Pre Screening Application

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Adelphi Residential Life Program Pre Screening Application

Students who wish to participate in the NCC/Adelphi Residential Life Program must complete the following application and meet the following requirements:

Be registered as a full-time NCC student (minimum 12 credits and/or credit equivalent).
Complete a Housing Agreement with the Adelphi University Office of Residential Life
Pay a $300 housing deposit to Adelphi University.

The information contained in this prescreening application will be shared with Adelphi University. Adelphi University will issue you an account to pay the housing deposit. Please check your NCC email for the account information.

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Legal Name

First Name*

Middle Name

Last Name*

Preferred Name

First Name

Middle Name

Last Name

Contact Info

NCC Email Address*

Personal Email Address*

Mobile/Cell Number*

Home Phone Number

Permanent Address

Address*

City*

State*

Zip*

Mailing Address

Address

City

State

Zip Code

Other Information

Date of Birth*

NCC Student IDN000000

Gender

Female

Male

Student Attributes

International Student

Athlete

Veteran

(Select all that apply)

Programs & Courses

Continuing Education

Financial Aid

Payment

Admissions

Registrar

Academic Advisement

Placement Testing