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Liew Family International Center Overnight Stay Application Form


STUDENT INFORMATION TO BE COMPLETED BY THE STUDENT
* Full Name:
* Date of Birth:
* Phone:
 
* Current Address:
* City: * State/Country:
 
Zip Code:
* CWID#: SEVIS Number:
 
* Gender:
* Expected Graduation Term:
* Graduation Year:
* Level:

STAY INFORMATION DATES REQUESTED
* Check-in Date:
* Check-in Time:
* Check-out Date:
* Check-out Time:
* Total number of nights:
* Special Needs:
* Need ride to the airport?
* I have read and agree to the terms of use of this facility, including payment of $20/night due upon arrival. I understand that violation of Liew Family International Student Center Policy could lead to the revocation of my privileges related to the use of the facility.
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