To complete the application, please fill out the form below and press the submit button. If you wish to clear the form and start over, press the clear button. The fields labeled in red are required, and the application will not be processed if they are empty. The application below is for the Academic Year 2014-2015 (Fall 2014 and Spring 2015).

Please use our Contact Us page at the top right if you are interested in just Spring 2015.

This page and all data you send through it is encrypted for your security.

Student Information


Last Name


First Name

    Middle Initial       

Social Security Number




Birthdate [mm/dd/yyyy]


High School



       Study Habits        Morning Afternoon Evening
Late Night

       Hobbies/Activities        Sports Fitness Current Events
Music Socializing


How Did You Hear About Naismith?




if Current or Former Resident
please enter name:

Student Address


Home Street Address 1


Home Street Address 2


Home Street Address 3




State or Province


ZIP/Postal Code




Home Phone Number


Cell Number


Parent / Emergency Information


Parent Last Name


Parent First Name


Parent Social Security Number


Parent Home Phone


Parent Emergency Phone


Parent Email Address


Emergency Relationship


Residential Data


Requested Room & Board Type (includes local sales taxes)



Alternate Room & Board Type (includes local sales taxes)


  When available: Parking Space Request ($300)


Mini Fridge / Microwave ($120)


University/College Attending


Year in College


Previous Housing


Student Email Address


Billing Email Address


UID Number (if unknown, leave "0")


Roommate/Suitemate Request

If you wish to be roommates or suitemates with certain people please indicate that in this section. Naismith Hall will only honor mutual roommate requests. The other person(s) with whom you would like to live must also request you as a roommate in his or her Room and Board Agreement Addendum. Room assignments are made on a first-come-first-served basis.

  Roommate Request  
       Suitemate 1 Request       
       Suitemate 2 Request       

Down Payment/Credit Card Information

Naismith Hall requires prospective residents to pay a $50 non-refundable processing fee.


Credit Card Type


Credit Card Number


Expiration Date [mm/yyyy]


CVN (What is this?)


Cardholder Name


Cardholder Address


Cardholder City


Cardholder State/Province


Cardholder ZIP/Postal Code

I hereby acknowledge that I have received, read, understand, and agree to the terms and conditions contained in the Naismith Hall Room and Board Agreement. I agree to be bound to the Room and Board Agreement terms and rates for the 2014/2015 Academic Year as indicated on the Room and Board Agreement Addendum. FOR VALUE RECEIVED, and in consideration for, and as inducement to The Bromley Group of Companies, Inc, as the AGENT for Naismith Hall, making the foregoing Agreement, the undersigned guarantees to the AGENT full payment and performance by the STUDENT of his or her obligations under the Agreement without requiring notice of non-payment, non-performance, or proof of notice or demand, all of which the undersigned expressly waives, and the undersigned expressly consents to any modifications of the Agreement, including but not limited to extensions of the term of the Agreement and adjustments to the room and board rates contained in the Agreement, and any extensions of time or indulgences granted by the AGENT to the STUDENT. I HAVE READ AND UNDERSTAND THE REFUND AND LIABILITY PROVISIONS CONTAINED IN THE AGREEMENT. I hereby authorize my electronic signature as submitted herewith to be as valid and binding as my original signature. Room and Rates Comparison.

Check this box to indicate your acceptance of the above statements.
Thank you for your interest in Naismith Hall at the University of Kansas. After you click on the submit button, your down payment will be processed and your completed application will be processed as soon as possible.

Online Payments