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House Decision Card / For students on leave of absence Part A: General Information (required) Name Class year ID number Campus box E-mail address Former campus house (before taking leave of absence) Address, or email address, to which housing assignment should be sent   Part B: Proxy Information (optional) If you would like to have someone other than the head resident/residence coordinator select a room for you during room draw (or draw a number during a special lottery), please provide her name here. Proxies not listed here are required to bring written permission from you to Room Draw or the special lottery. Remember, all houses participate in Room Draw at the same time; therefore, your proxy should be a resident in your house, a senior, or a student who is taking a leave of absence for the Fall Semester. Full name ID# Class Please note that the id number of your proxy, while helpful, is not required Part C: Action (required)     Return to former house for 2008-09 (STOP here and return form)    Enter lottery for change of house (please complete parts D and E) Part D: Enter Housing Lottery (Optional; complete if you checked "enter lottery for change of house" in Part C.) Please select and rank five house preferences (type in house code): 1 2 3 4 5 400 Albright 401 Baldwin 404 Capen 406 Chapin 410 Comstock 412 Cushing 413 Cutter 419 Duckett 421 Emerson 423 Gardiner 424 Gillett 427 Haven/Wesley 433 Hubbard 435 Jordan 436 King 438 Lamont 439 Lawrence 441 Morris 443 Morrow 445 Northrop 446 Park Complex 449 Parsons Complex 452 Scales 453 Sessions Complex 456 Talbot 457 Tyler 460 Washburn 464 Wilder 466 Wilson 468 Ziskind Part E: Special Lotteries (Optional; complete if you checked "enter lottery for change of house" in Part C.) Do you wish to enter any of the special lotteries? Yes No If yes, indicate which lotteries to enter. The special lotteries will be conducted in the order they appear below. As a result, you may not enter the Off-Campus Lottery after the Friedman and/or Chase lotteries, and you may not enter the Chase Lottery before the Friedman Lottery (EX: If your number is drawn in the Off-Campus Lottery, you will not be entered into the Friedman or Chase House lotteries) Off-Campus Lottery (seniors only; release from on-campus residency requirement) Friedman Apartments Lottery If yes, please complete the apartment group section (PART F) below. Your group must consist of four or six students to enter the lottery.  Chase House Lottery (senior house, seniors only) If your number is not drawn for any of these special lottery options, would you like to:   Return to your former house, as listed in Part A, or   Enter the Housing Lottery for a change of house (complete Part D).   Please add my name to the waiting list for Dawes House (French house).* *The house coordinator for the appropriate house will contact you if a space becomes available. Part F: Friedman Lottery (Optional; complete if you entered the Friedman Lottery in Part D.) Please list the members of your group. Groups must consist of four or six members. Most Friedman apartments have four spaces. 1 ID# Class 2 ID# Class 3 ID# Class 4 ID# Class 5 ID# Class 6 ID# Class Who is your apartment contact person? Phone (before May 12, 2008) Alternate phone NOTE: Failure to return this form to the Office of Residence Life before January 2, 2008, will result in your assignment for housing being made during the summer lottery. If you have questions or cannot use this form, please call the housing office (413) 585-4940.

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Smith College // Northampton, Massachusetts 01063 // (413) 585-4940



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Page maintained by the Office of Student Affairs. // Last update: March, 2008.