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Oberlin Student Cooperative Association
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New Student Lottery Form
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New Student Lottery Form
PERSONAL INFORMATION
First Name
*
This is your legal given name. If you have a preferred name, you will have an opportunity to enter that elsewhere.
Last Name
*
Your surname or family name.
Middle Name or Initial
Preferred First Name
If you have a different name on file with Oberlin College, enter it here.
A you an international student?
*
No
Yes
ENROLLMENT INFORMATION
T-Number
*
Enter your Oberlin College student ID number. Omit the beginning "T0".
T0
OCMR Number
*
Enter "0000" if you have not yet received your Oberlin College Mail Room number.
Enrollment Status
*
New, incoming first-year student
Transfer student
CONTACT INFORMATION
Street address
*
Number and street address.
Street address (line 2)
*
Additional street address information.
City
*
Enter your city, municipality, or township information.
Postal Code
*
State or Province
*
Enter your state or province information.
Country
*
Primary Telephone
*
Secondary Telephone
Email Address
*
Confirm Email Address
*
Please re-enter your email address.
CO-OP PREFERENCES
Please make each co-op selection only once. You MUST choose at least ONE co-op. If you choose Old Barrows or Third World Co-ops you must fill out an additional application to those individual co-ops in order to be placed there during the lottery. If you choose Old Barrows Co-op, you MUST also choose a dining co-op as Old B is housing-only.
1st Choice Co-op
*
- Select -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
2nd Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
3rd Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
4th Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
5th Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
6th Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
7th Choice Co-op
- None -
Fairchild Co-op
Pyle Inn
Third World Co-op
Old Barrows Co-op
Harkness Co-op
Keep Cottage
Tank Co-op
ROOMMATE PREFERENCES
My gender is:
*
I am comfortable with any roommate, regardless of assigned sex or gender identity.
*
YES
NO
Gender(s) I am comfortable living with:
Gender(s) I am uncomfortable living with:
I would like to live with someone who is comfortable with any roommate, regardless of assigned sex or gender.
*
YES
NO
ACCESSIBILITY IN CO-OPS
Additional information regarding OSCA's accessibility policies can be found on OSCA's web site http://oberlin.edu/osca. This information is protected by
OSCA's confidentiality policy
.
Note:
Only the OSCA Officers and employees responsible for maintaining the wait list and OSCA staff responsible for accessibility and/or nutrition will have access to the names of the persons who check these boxes.
By choosing
not
to check these boxes, you are not excluded from receiving potential accommodations at any point during your membership in OSCA. Once in OSCA, all members will receive information regarding OSCA's accessibility policies.
Accessibility Committee Coordinator
Select "yes" if you would like to be contacted by an OSCA Accessibility Committee Coordinator for information about OSCA's policies regarding accommodations for the following: members with disabilities, members seeking alternative eating arrangements, need-based singles, housing for transgender students, and students with financial need.
YES
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