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Iowa Central Room & Board Contract

PRIORITY DEADLINE for out of state or non-residential students is June 1, 2013.

Effective March 1st, 2013, Room & Board Contract fee is $300 for non-residents or $100 for in state residents.

The Room and Board Contract between Iowa Central Community College and applicant is for one full academic year beginning with the fall semester and ending at the end of the spring semester and academic year.

Before submitting this contract, please read the terms and conditions of room and board contract

Please Note: Any resident who does not complete the contract agreement will be assessed a $600.00 Violation of Contract Fee. The Violation of Contract Fee will not apply for the following reasons: marriage, death, graduation, or if the resident notifies the College that he/she will be transferring before the end of the Contract Agreement.

Personal Information
Start Term: Please select an item.
Start Year: A value is required.
Applicants College Classification:
First Name:
A value is required.		 Middle Name/Initial:
Last Name:
A value is required.		 Sex:
SSN: Birthdate:
Address:  
City: State:
Zip Code: Home Phone:
A value is required.
Invalid format.
E-mail
A value is required.
Invalid format.		 High School GPA:
A value is required.

Parent/Guardian Information
Name:    
Address: City:
State: Zip Code:
Home Phone:    

Honor Dorm

Are you interested in living in our Honor Apartment?
Student must have a cumulative high school GPA of a 3.25 or higher. Living the Honor Dorm this may affect your roommate preference.


Roomate/Special Needs/Meal Plan

Roomate preference, By Name/Roomate Preference by Academic Program:

Special Needs:
 Click here here if you have special needs that should be considered in making your assignment. If you need assistance or have a disability, a written description of the accommodation you request plus documentation (such as a letter of explanation from you and your health care provider) should be sent by you to Iowa Central Community College Coordinator of Special Populations, attention: Heather Lundberg, One Triton Circle, Fort Dodge, IA 50501, or by email to Lundberg@iowacentral.edu.
Click here if you DO NOT have special needs to be considered in making your assignment

Have you been dismissed from a post-secondary educational institution within the past three years? Please select an item.

If the answer is “Yes” to the above question: I state that the following reason(s) lead to the dismissal and provide the name of the educational institution:

By submitting this Application I authorize the above named educational institution to disclose to Iowa Central Community College’s Vice President of Enrollment Management & Student Development the information from my educational records as to the reason(s) for the dismissal.

Meal Plan Options*
Room & Board/19 meals per week - $5650.00
*subject to change after Board approval and prior beginning of contract year.


Terms and Conditions

Please read Terms and Conditions before submitting this contract. This contract will not be processed unless all information requested above and the deposits have been received.

Contractual Responsibilities
Please read Terms and Conditions before submitting this contract. This contract will not be processed unless all information requested above and the deposits have been received.

I hereby apply for Room and Board for the academic year or the balance thereof. I have read and agree to abide by the terms and conditions of the Room and Board Contract as stated. I confirm that I have never entered a guilty plea or an Alford Plea to a felony offense or to a sex offense, been placed on probation for or entered into a diversion program for a felony or a sex offense, or been convicted of a felony or of a sex offense. I have sent/will send the $300 for non-resident or $100 for in state resident non-refundable application fee. Check or money order has been made payable to Iowa Central Community College.

Check or money order has been made payable to:
Iowa Central Community College

Send the application fee to:
Iowa Central Community College
One Triton Circle
Fort Dodge, IA 50501