92Y Residence - Application

92YResidence Application

Please be advised that the completed application is NOT a confirmation. This application is not confirmed and space is not booked for you at 92Y Residence until we have processed the administrative fee. This fee is not applicable to rent.

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Application Overview:

A non-refundable administrative fee of $250.00 will be charged upon submission of this application providing you meet our eligibility requirements and we can accommodate your request for housing. Please fill in your credit card information at the end of the application.

You can also download Application [PDF] and Rules and Regulations [PDF]

Groups Rules/Regulations [PDF].

New Application * = required field

Basic Info

First Name *

Middle Initial

Last Name *

Phone *

Email *

Gender *

FemaleMale

Date Of Birth*

Age*

Height*

How Did You Hear About Us? *

Permanent Address *

City *

State *

Postal Code *

Country *

Most Recent School/Employment History

School *

Degree *

Years Attended *

Phone *

City *

Place of Employment *

Position *

Employment Period *

Supervisor *

Phone *

What you will be doing while you reside in New York?

Please provide specific contact information in New York for verification

School/Internship/Job *

Program/Title *

Program Duration *

Supervisor *

Phone *

In Case of Emergency Notify

Name *

Relationship *

Address *

City, State/Country *

Telephone *

Room Preference

Drag the room types you are interested in from the list of available rooms to the list of preferred rooms in the order you prefer.
Leave any room types you do not want to be considered for in the available rooms list. *

Available Rooms

Small Double Room with 1 closet
Regular Double Room
Single Room
Large Single Room

Preferred Rooms

Is there anything else you would like to tell us about yourself that would allow us to best place you in our communal residence facility?

Length of Stay

Arrival *

Departure *

Tell us about yourself. Why do you want to live at 92Y Residence? *

Promo Code

Do you have a promo code? Enter it here

Billing

First Name *

Last Name *

Relationship **

Phone *

Email *

Address--Line 1 *

Address--Line 2

City *

State *

Postal Code *

Name on Card *

Card Type *

Card Number *

Expiration Month *

Expiration Year *

** Enter relationship above if billing name is different from applicant

Please read carefully

A non-refundable administrative fee of $250.00 will be charged upon submission of this application providing you meet our eligibility requirements and we can accommodate your request for housing. This fee is not applicable to rent.
All 92Y residents must attend an orientation to be held within two weeks after arrival.
Residence is limited to students/interns and/or fully employed men and women.
Minimum residence is one month. Maximum stay is one year.
Your residence is limited to the time period you indicated above. To extend your stay, a two-week written notice is required and approval is subject to availability. If you decide to move out prior to your departure date indicated above, we require a one-month written notice (exception: the Fall semester where we require a full four-month commitment from Sep 1 through Dec 31. If you move out prior to Dec 31, rent must be paid through Dec 31).
Rent is always due in advance on the 1st of every month.
Based upon the information obtained by 92Y Residence Department, the Residence Department Admissions Committee shall in its discretion determine whether the applicant will be able to benefit from the experiences of dormitory/group living at 92Y, and will not be detrimental to him/herself and/or other 92Y residents. Meeting these standards is a prerequisite to admission to the 92Y Residence. In applying these standards, the Admissions Committee shall consider the relevant factors, including but not limited to the safety, morals and comfort of 92Y residents, as well as the purposes of the 92Y Residence Department.
Termination of residence may be given at the discretion of 92Y for any breach of the rules and regulations as in effect from time to time. The determination of such breach shall be made at the sole and absolute discretion of 92nd Street Y.

In addition please review the Rules and Regulations / Group Rules and Regulations.

I have read and agree with the statements above as well as the Rules and Regulations. *

AgreeDisagree

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