Housing Application: Student Information

This housing application is for NEW students only. Returning students should fill out a returning student housing form. Read more information for returning students.

Required fields are highlighted with a .

Concordia G#

(What is Concordia G#?) Your G# is your Concordia student identification number.
You can find it listed on your financial aid packet or by
calling CU Admissions at 503-280-8501, or toll-free at
1-800-321-9371.

Legal First Name

Middle Initial

Last Name

Birth Date

Gender

Male
Female

Primary Phone (cell phone preferred)
() -

Secondary Phone
() -

E-mail Address

Housing Request is for

Mailing Address (include PO Box or apartment number if applicable)

Mailing Address Line 2

City

State/Province

Country

ZIP or Postal Code

Major/Degree Considering

Student Type

Transferring from where if you select transfer student above

Do you have health insurance? *

Health/Medical Insurance Company

Policy #

Please note any allergies (smoke, food, etc...), medical conditions (asthma, etc...) or special needs:

Do you have a housing related need that requires accommodation under ADA (Americans with Disabilities Act)? If you do, please explain below. NOTE: the Housing Accommodation Request form and appropriate documentation is required.

* Health insurance is required. Click here to waive University insurance or establish your health insurance through Concordia.

Questions? Problems with this form? Contact Student Services at housing@cu-portland.edu or 503-280-8512 or 1-800-321-9371.

Concordia University, Portland

Housing Application: Student Information

Please note any allergies (smoke, food, etc...), medical conditions (asthma, etc...) or special needs:

Do you have a housing related need that requires accommodation under ADA (Americans with Disabilities Act)? If you do, please explain below. NOTE: the Housing Accommodation Request form and appropriate documentation is required.