Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal details in the designated fields. Provide your first name, last name, home address, city, state, and zip code.
3. Fill in your contact information by entering your home number and cell number. This is important for communication regarding your application.
4. Input your date of birth and select your gender from the options provided.
5. Indicate your marital status by selecting either single or married.
6. Provide information regarding your intended entry month and year into the Residence Hall.
7. Answer whether you have any chronic ailments or physical disabilities. If yes, please provide an explanation.
8. If you have a preference for a roommate, indicate their name in the appropriate field.
9. Note that acceptance of this application does not guarantee housing or academic admission. Ensure you understand this before proceeding.
10. Indicate whether you have applied for admission to Coahoma Community College and disclose any felony convictions, providing explanations if necessary.
11. Complete the insurance information section by entering your group number and policy number.
12. Review your application for completeness. Once you are satisfied that all information is accurate, you will be required to sign by entering your signature and the date.
13. Save a copy of the application using your first and last name along with the semester and year you will attend. For example, Eugene Polite Fall 2023.
14. Submit your application by emailing it to ccchousing@coahomacc.edu. Include the required deposit fees: $100.00 for fall and spring or $25.00 for the summer session. Payments should be made via money order, payable to Coahoma Community College.
15. Keep in mind the application deadlines: June 15 for fall and December 15 for spring.

Complete your Coahoma Community College Housing Application online today to secure your housing!