Consumer Product Sustainability Workshop Registration

URI Student ID Number

Name*

First Last

Local Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Permanent (Home) Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone (US)

Cell Phone (International)

Email*

Gender Identity*

Female
Male
Non-binary/ third gender

Please check all programs you are part of:*

Chinese IEP
French IEP
German IEP
Italian IEP
Japanese IEP
Spanish IEP
Chinese Flagship
Foreign Exchange Student
Other

Other Programs

What other programs are you involved with?

Please list your major(s)*

Credits Completed*

Please entered number of completed credits as of most recent completed semester.

Cumulative GPA*

How many semesters have you studied abroad, including the current semester?*

List any current campus involvement or other extracurricular activities, including employment.

Housing Preferences

I desire housing for which semester(s)?*

Academic Year (Fall & Spring)
Fall Only
Spring Only

I understand that there are penalties (outlined in this contract) for breaking this agreement*

Yes, I understand the consquences

Electronic Signature (Full Name)*

What are you doing in the Fall?*

International Internship
Studying Abroad
I will have graduated

What are you doing in the Spring?*

International Internship
Studying Abroad
I will have graduated

I prefer to live in the:*

IEP House
Texas Instruments House
No preference

I prefer a:*

Single Room
Double Room

Do you have any dietary restrictions or other concerns you would like us to be aware of?*

Roomate*

I do not have a preferred roommate. (IEP staff will assign a roomate)
I have a preferred roomate.

Who is your preferred roomate?*

First Last

German IEP & TUBS/TUDa Students: Are you interested in living on the Max Kade German Language Floor of the TI House?

Yes
No

Which GER course are you taking in the fall?

Which language wing would you prefer?*

Pending availability

Chinese / Japanese
French / Italian
Spanish
No Preference

Are you in good disciplinary standing at the University of Rhode Island?*

Please explain your disciplinary standing.*

By providing my electronic signature below, I agree that:

If admitted, I am prepared to pay a NONREFUNDABLE deposit of $250 within a week of acceptance. (This deposit will be applied as a credit on your spring semester bill.)
I have read and understand the Statement of Purpose, the Housing Contract, and the House Rules & Regulations.
I understand that I am committing to a two-semester rental contract (9/3/24—5/8/25) and have reviewed the penalties for breaking this contract.
I consent for the release to IEP staff of information regarding any disciplinary information from the Dean of Students Office.

Electronic Signature (Full Name)*

If you have a room/building preference please list them in order.

First Choice: Second Choice: Third Choice:

Name

This field is for validation purposes and should be left unchanged.

College of Engineering

Consumer Product Sustainability Workshop Registration

Housing Application