Dormitory Application Form

“Note: Please submit this application 30 days before the scheduled check-in date. 請在預定入住日期前30天提出此申請。

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This field is for validation purposes and should be left unchanged.

Applicants Must Complete This Form

Long term / monthly rate:

Two types of accommodation available in our dorm I: studio for single and one bedroom for family
Consult with dorm management team at 626-571-5110 or email at dormitory@les.edu on current rates.
We reserve the right to adjust the rates on a yearly basis

Daily rates are available for short-term stay based on availability for. Consult with dorm management team at 626-571-5110 or email at dormitory@les.edu on rates and availability.

宿舍介紹 & 用戶手冊

請觀看正道宿舍介紹視頻 Please Watch the introductory video of the dormitory:(Required)

請務必觀看四分鐘的介紹視頻,看完請勾選下面的選項。Please be sure to watch the introductory video before submitting this form:

已經觀看了Already watched.

請點擊下載並閱讀此住戶手冊 Please download and read carefully:(Required)

請點擊下載並仔細閱讀此住戶手冊，同意請勾選並簽名。Please click to download and carefully read this Handbook. Please check the box and sign if you agree.

同意遵守宿舍住戶手冊內全部的規定. I agree to the policy.

請簽名 Signature(Required)

Applicants Information

English Name(Required)

First Last

中文姓名(Required)

(N/A if you don’t have a Chinese Name)

手機 Cell Phone(Required)

電郵 Email(Required)

Enter Email Confirm Email

Your Age(Required)

性別 Gender(Required)

連絡地址 Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

申請者的身份 Applicant

正道在校學生（Full-time, Part-time 或密集班學生）Logos Students

Student ID number(Required)

Full-time or Part-time Student?

請選擇您在正道的科系(Required)

請填寫您所屬教會/機構 Church/Org

Emergency Contact Information

Name(Required)

First Last

中文姓名

Phone(Required)

Lodging

Move in Date(Required)

Note: The move-in date must be 1 month later!

Time(Required)

Move out Datee(Required)

Time(Required)

Select The Room Type(Required)

Studio (only for one person)

One-Bedroom (a couple or family)

Share one-bedroom (no more than 2 person and same-gender only )

Other occupants(Required)

Spouse

Children

Spouse's Name(Required)

First Last

Children(Required)

Name

Age

Other Occupants

Name

Relationship

Notice

Your Message

Your Enquiry?

Reservation Deposit

Dorm Reservation Deposit(Required)

Price:

Total

Credit Card(Required)