First, middle initial, last name:

Permanent street address:

Permanent city, state, zip:

Country:

Phone:

E-mail:

Date of birth:

Gender: male     female

Check here if you have already submitted an electronic University Housing/Dining Services Contract. Please note that your application will not be considered unless a separate housing contract has been received in the housing office.

Global Village residents must abide by Global Village guidelines, which include a willingness to do the following:

• Broaden your world view and support the Global Village by attending at least five Forums per term.
• Participate in at least one Global Village community planning meeting per term.
• Come with an open mind and be tolerant and respectful of the views of community members and guest speakers.
• Assist in Global Village evaluation efforts in collaboration with Residence Life and UCIS.
• Respect and abide by University of Pittsburgh policies and regulations.

By checking the box below, I understand that my acceptance and continued residence on the International Studies Living Learning Community floor is contingent upon my adherence to the principles as outlined above:

Yes, I agree with the terms stated above.

What is your academic class for the upcoming year?

Academic school (CAS, CBA, Engineering, Nursing) to which you have been admitted:

Academic major:

Full name of roommate preference (if you have one):
In order to be placed together, your preferred roommate must also apply and be accepted into the Global Village.

Check here if you still wish to be considered for membership in Global Village in the event that this roommate preference cannot be met:

Please answer the following questions:

1. What personal or academic experiences and interests have prepared you to participate in an international community?

2. What experiences have you had with cultures other than your own?

3. How will living in the Global Village relate to your education?

4. What can you contribute to the Global Village? (past experience, skills, talent)

If you are a returning student:
5. What suggestions do you have for next year’s programming,