HUFS GLOBEE Dorm Application (Seoul) (On-Campus Residence)

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HUFS GLOBEE Dorm Application (Seoul) (On-Campus Residence) Due to the limited capacity in our Globeedorm, there is NO GUARANTEE that you will receive a room if you submit this application form and health examination form after the deadline. Please complete and return this application to: Office of International Student Services (OISS) 107 Imun-Ro, Dongdaemun-Gu, Seoul, Korea 130-791 Phone : 82-2-2173-2065 Fax : 82-2-2173-3387 FOR OFFICE USE ONLY : / / Receipt No.: Signature : HOW TO APPLY & ` PAY 1. Complete this application and fax or mail it to our office as early as possible. 2. This application MUST be submitted to OISS before the Exchange/Study Abroad application deadline in order for OISS to process your application in time for your check-in. 3. Payment for each term should be made in Korean WON during the first week of your program of study at HUFS after your arrival. Please note that we do not accept credit cards. PERSONAL INFORMATION ` Gender(Please check) : MALE FEMALE Nationality: HOME University : Phone Number: Email Address: Please contact your international office to check if you are qualified to receive free accommodation. ACCOMMODATION REQUEST ` International exchange students will be assigned to Double rooms. Period Months (Number of weeks) CHECK RATES (Korean WON) DOUBLE ROOM Spring semester Fall semester March June (16 weeks) 1,060,000 March August ( 24 weeks) 1,660,000 September December (16 weeks) 1,060,000 September February ( 24 weeks) 1,660,000 March December (40 weeks) 2,720,000 Two semesters March February (48 weeks) 3,320,000 September June (40 weeks) 2,720,000 September August (48 weeks) 3,320,000 Meals are not included / No Cooking facilities are provided - Please visit our office s website to find out information about check-in/check-out dates - If you take only one Korean language term which lasts 10 weeks and leave for home, you are responsible to pay for the entire semester(16 weeks) - If you need to stay on campus beyond our schedules, contact us for special arrangements.

Health Statement & SPECIAL ` REQUESTS 1. Do you smoke? YES NO 2. I usually go to bed at 22:00 24:00 02:00 3. Do you have serious health problems or require disability support? YES NO 4. Have you completed Health Examination Form with a doctor s signature? YES NO 5. If you have other special requests, please specify : Conditions of the contract and payment 1. You are to arrive on the official check-in dates specified by HUFS Office of International Student Services (OISS). 2. If you expect to arrive later than the official check-in date, you must notify OISS of your planned date of arrival in writing by fax or email. If not, your housing arrangement will be canceled due to no show policy. 3. A 40,000 Won deposit is required from all dormitory residents. A 30,000 Won will be refunded at the time of check-out after going through an official room check-up and return of the card key. 4. You must pick up a bill at the GlobeeDorm office located on the first floor of the building and pay your dormitory fee during the first week of each semester or vacation term. If you fail to make timely payments, your contract may be terminated. 5. If you decide to cancel your dormitory contract after you check-in, you must submit a cancellation form to the GlobeeDorm office within the first week of the semester (by Friday 5pm) to get a refund of 75% of the dormitory fee. Any cancellation after this period will result in no refund. 6. You must keep curfew at the GlobeeDoam and be in your room by midnight for safety reasons. If you plan to spend an overnight at other places, you must report to the GlobeeDorm office in advance or you will receive penalty points. 7. All successful dorm applicants are required to submit proof of health examination results (see our Health Examination Form) before arriving on campus. In case of staying for 2 semesters, applicant must submit health examination result again before the beginning of second semester. 8. You are to move out on the official check-out dates, which is the last day of HUFS regular semester. For students who take the 10 week Intensive Korean Language Program during summer or winter vacation, the official check-out date is the last day of the Language Program. No late check-out will be available in any cases. 9. You should abide by all rules of the dormitory. I hereby declare that I have read and understand this regulation and I understand that if I do not abide by these rules to which I have agreed, HUFS has the right to cancel this contract and I will be asked to move out of the Globeedorm without any refund. Signature

HUFS Int l House (A) Application (Seoul) (Off-Campus Residence Female Only) Due to the limited capacity in our Int l House, there is NO GUARANTEE that you will receive a room if you submit this application form and health examination form after the deadline. Please complete and return this application to: Office of International Student Services (OISS) 107 Imun-Ro, Dongdaemun-Gu, Seoul, Korea 130-791 Phone : 82-2-2173-2065 Fax : 82-2-2173-3387 FOR OFFICE USE ONLY : / / Receipt No.: Signature : HOW TO APPLY & ` PAY 1. Complete this application and fax or mail it to our office as early as possible. 2. This application MUST be submitted to OISS before the Exchange/Study Abroad application deadline in order for OISS to process your application in time for your check-in. 3. Payment for each term should be made in Korean WON during the first week of your program of study at HUFS after your arrival. Please note that we do not accept credit cards. PERSONAL INFORMATION ` Sex : FEMALE Nationality: HOME University : Phone Number: Email Address: @ ACCOMMODATION REQUEST ` Period Months (Number of weeks) RATES (Korean WON) Double Room Every semester( Spring / Fall ) 1,380,000 Vacation Period( Summer / Winter ) 690,000 Meals are not included / Cooking facilities are available - This residence is exclusively open only to female students - - If you take only one Korean language term which lasts 10 weeks and leave for home, you are responsible to pay for the entire semester(16 weeks) - If you need to stay on campus beyond our schedules, contact us for special arrangements.

Health Statement & SPECIAL ` REQUESTS 1. Do you smoke? YES NO 2. I usually go to bed at 22:00 24:00 02:00 3. Do you have serious health problems or require disability support? YES NO 4 Have you completed Health Examination Form with a doctor s signature? YES NO 5. If you have other special requests, please specify : Conditions of the contract and payment 1. You have to arrive on the official check-in dates specified by HUFS Office of International Student Services (OISS). 2. If you expect to arrive later than your indicated move-in date, you must notify OISS of your planned date of arrival in writing by fax or email. If not, your housing arrangement will be canceled due to no show policy. 3. The dorm fee covers up to KRW 50,000 utilities fee (Water, Electricity, Gas) per one month and A KRW 100,000 dorm security and utility deposit is required from all dormitory residents and is refundable upon a satisfactory checkout of the residence. A deposit refund may be reduced to pay for the repairs of any damaged items or overuse of any utilities. 4. You must pay your dormitory fee during the first week of each semester or vacation term and if you fail to make timely payments, your contract may be terminated. 5. If you choose to move out of the dorm before the term ends, the dormitory fee will be refunded to you in accordance with the schedule described in our International House Regulation. 6. We do not accept any requests for monthly billing. 7. All successful dorm applicants are required to submit proof of health examination results (see our Health Examination Form) to waive the medical exam before arriving on campus. In case of staying for 2 semesters, applicant must submit health examination result before the beginning of each semester. 8. You have to move out on the official check-out dates, which is the last day of HUFS regular semester. For students who take the 10 week Intensive Korean Language Program during summer or winter vacation, the official check-out date is the last day of the Language Program. No late checkout will be available. 9. You should abide by all rules of the dormitory. If you want to terminate this contract, you should notify OISS in writing. I hereby declare that I have read and understand this regulation and I understand that if I do not abide by these rules to which I have agreed, HUFS has the right to cancel this contract and I will be asked to move out of HUFS Int l House without any refund. Signature

HUFS Int l House (B) Application (Seoul) (Off-Campus Residence) Due to the limited capacity in our Int l House, there is NO GUARANTEE that you will receive a room if you submit this application form and health examination form after the deadline. Please complete and return this application to: Office of International Student Services (OISS) 107 Imun-Ro, Dongdaemun-Gu, Seoul, Korea 130-791 Phone : 82-2-2173-2065 Fax : 82-2-2173-3387 FOR OFFICE USE ONLY : / / Receipt No.: Signature : HOW TO APPLY & ` PAY 1. Complete this application and fax or mail it to our office as early as possible. 2. This application MUST be submitted to OISS before the Exchange/Study Abroad application deadline in order for OISS to process your application in time for your check-in. 3. Payment for each term should be made in Korean WON during the first week of your program of study at HUFS after your arrival. Please note that we do not accept credit cards. PERSONAL INFORMATION ` Gender(Please check) : MALE FEMALE Nationality: HOME University : Phone Number: Email Address: ACCOMMODATION REQUEST ` Period Months (Number of weeks) RATES (Korean WON) Double Room Every semester( Spring / Fall ) 1,380,000 Vacation Period( Summer / Winter ) 690,000 Meals are not included / Cooking facilities are available - If you take only one Korean language term which lasts 10 weeks and leave for home, you are responsible to pay for the entire semester(16 weeks) - If you need to stay on campus beyond our schedules, contact us for special arrangements.

Health Statement & SPECIAL ` REQUESTS 1. Do you smoke? YES NO 2. I usually go to bed at 22:00 24:00 02:00 3. Do you have serious health problems or require disability support? YES NO 4. Have you completed Health Examination Form with a doctor s signature? YES NO 5. If you have other special requests, please specify : Conditions of the contract and payment 1. You have to arrive on the official check-in dates specified by HUFS Office of International Student Services (OISS). 2. If you expect to arrive later than your indicated move-in date, you must notify OISS of your planned date of arrival in writing by fax or email. If not, your housing arrangement will be canceled due to no show policy. 3. The dorm fee covers up to KRW 50,000 utilities fee (Water, Electricity, Gas) per one month and A KRW 100,000 dorm security and utility deposit is required from all dormitory residents and is refundable upon a satisfactory checkout of the residence. A deposit refund may be reduced to pay for the repairs of any damaged items or overuse of any utilities. 4. You must pay your dormitory fee during the first week of each semester or vacation term and if you fail to make timely payments, your contract may be terminated. 5. If you choose to move out of the dorm before the term ends, the dormitory fee will be refunded to you in accordance with the schedule described in our International House Regulation. 6. We do not accept any requests for monthly billing. 7. All successful dorm applicants are required to submit proof of health examination results (see our Health Examination Form) to waive the medical exam before arriving on campus. In case of staying for 2 semesters, applicant must submit health examination result before the beginning of each semester. 8. You have to move out on the official check-out dates, which is the last day of HUFS regular semester. For students who take the 10 week Intensive Korean Language Program during summer or winter vacation, the official check-out date is the last day of the Language Program. No late checkout will be available in any cases. 9. You should abide by all rules of the dormitory. If you want to terminate this contract, you should notify OISS in writing. I hereby declare that I have read and understand this regulation and I understand that if I do not abide by these rules to which I have agreed, HUFS has the right to cancel this contract and I will be asked to move out of HUFS Int l House without any refund. Signature

Health Examination Form for All Dormitory Applicants Important: All successful applicants who need our university housing are required to submit proof of an authorized health exam result(including Hepatitis Type B and tuberculosis) prior to arrival in Korea, in accordance with the requirements of the Korean Immigration Service and our dormitory regulation. Please check your housing type 1. ON-CAMPUS HOUSING: GlobeeDorm 2. OFF-CAMPUS HOUSING: International House A / International House B I. Personal Information of Birth(dd/mm/yy): / / Gender: Male( ) Female ( ) Nationality: Home University: II. Personal Medical Assessment 1. Have you had any serious illness or injury that required hospitalization in the last two years? 2. Have you ever made repeated visits to a doctor for an illness or injury? 3. Have you ever had any of the followings? - hepatitis or tuberculosis? - close contact with any infectious disease? 4. Do you have any allergies? 5. Have you ever cared for by a mental clinician? If the answer to any of above questions is Yes, please provide the question number and specify in details below Question Number( ) I hereby state that information submitted on this form is true Student Signature III. Health Examination Report (This form is VALID only if completed and signed by a clinician) 1. Hepatitis Type B Results: HBsAg Positive Negative HBsAb or Anti-HBs Positive Negative HBcAB or Anti-HBc Positive Negative No Active or prior infection ( ) Immune ( ) New infection or chronic carrier ( ) Unclear ( ) 2. Tuberculosis of exam: a. Skin Test Result: of exam: If the tuberculosis skin test is positive (9.9mm or over) you must complete and submit b: b. Chest X-Ray : Normal Abnormal Clinician s Signature MD/NP/PA Name (Please Print) Signature Address Country Telephone Number