College Services

* denotes a required field

Student Information

1. First name*
2. Last name*
3. Address*
4. City*
5. State* Please select your state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington State West Virginia Wisconsin Wyoming
6. ZIP code*
7. E-mail*
8. Cell or room phone (with area code)*

College Information

1. Choose your college* --- Select College --- Concordia College North Dakota State University
Residence hall* Select your Residence Hall Erickson Fjelstad Hallett Hoyum Livedalen Brown - no lofting Park Region - no lofting
Room number (including letter designation, if applicable)*
Rental duration* Select your Rental Duration Semester Year
Choose your loft option*
Bed loft Bed loft with shelf No loft
Residence hall* Select your Residence Hall Ballard
Room number (including letter designation, if applicable)*
Rental duration* Select your Rental Duration Semester Year
Choose your loft option*
Bed loft Bed loft with shelf
Residence hall* Select your Residence Hall Burgum Living Learning Center Niskanen Sevrinson Thompson Cater - no lofting Churchill - no lofting Dinan - no lofting Johnson - no lofting Pavek - no lofting Reed - no lofting Seim - no lofting Stockbridge - no lofting North Weible - no lofting South Weible - no lofting
Room number (including letter designation, if applicable)*
Rental duration* Select your Rental Duration Semester Year
Choose your loft option*
Bed loft Bed loft with shelf No loft
Choose your fridge option*
3.6 cubic foot fridge 2.0 cubic foot fridge No fridge
Choose your microwave option*
Microwave No microwave
Total $

Rental Terms

1. Selecting this box is equivalent to signing your signature electronically.

   I Accept

Credit Card Information

1. Acceptable Card Types
   
2. Name on credit card*
3. Credit card number (no spaces)*
4. Expiration date (MM/YY)* 01 02 03 04 05 06 07 08 09 10 11 12 24 25 26 27 28 29 30 31 32 33 34
5. Security code *

WARNING: Select the Submit button only once. Selecting the button more than once may charge your card multiple times. If an error occurs, please contact us.