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Unformatted text preview: Ec EDMONDS •• COMMUNITY COLLEGE Edmonds Community College Sophie Court Application Housing Office 20000 68'h Ave. West Lynnwood. WA 98036-5912 USA Phone: 425-640-1080 Fax: 425-640-1057 Email [email protected] Web Site: http :/lhousing.edcc .ed u Housing Placement Fee $250 to be paid with application Airport Pick-up Fee $20 on arrival dates only 1 will nay fees hy: o credit card (information attached) o check (enclosed) o wire transfer *Scc Housing website for arrival dates, and payment Quarter Applying for: 0'Fall OWln'er OSpring OSummer Year '2.0I0 I. Last Name: NCrVY EN First Name: DUNG- Nationality: U d M !\!!Y lK M . Sex: Female __ Male ,/ Student ID/SS #: 'J5S' - pO- OFf GIt Date of Birth: fIl.-1.12.J :Jsg i Agc___ Month/Day/Year Home Address 1RC TON QVe. TttANC, , My B IN-H WARD City LONG- xVYEN State AN GIANG- Country V 1FT N A M Postal Code _ Telephone 01"-6- (;'2.50263 Fax _ Country Code/City Code/Number Country Code/City Code/Number G 7(,;) yA+tOO. U'JM Email Address tJC-U\1EN- n.\ DuN: '=& ' .. Local1'clephone. _ Current Addres.s (if different than abovc):. _ Emergency Contact Namc and Phone #: T\tfrN+I - 51Nti NfrUI:iI:.N 0303 g'2.5:t52....
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This note was uploaded on 10/18/2010 for the course DDD DD taught by Professor Dd during the Spring '09 term at Aarhus Universitet.
- Spring '09