{ "HOWARD COLLEGE HOUSING APPLICATION": { "Indicate the term and year for which you are applying": { "Academic Year": "2025-2026", "Mini": "18/05/2026", "Summer I": "06/01/2026", "Summer II": "07/06/2026", "Spring": "13/01/2026" }, "Name": { "Last": "Johnson", "First": "Emily", "Middle": "Grace" }, "Mailing Address": { "City": "Austin", "State": "Texas", "Zip": "79720" }, "E-Mail address": "jordan.martinez@example.com", "SS#": "472859316", "Howard College ID#": "10048273", "Cell Phone #": "4325557291", "Home Phone #": "4325551846", "Ethnicity": "White", "Date of Birth": "08/14/2004", "Roommate Preference": "Alex Thompson", "What is your area of study?": "Nursing", "Will you be a member of any school sponsored team or organization?": "Yes, student government association", "Emergency Contact Information": { "Parent/Guardian Name(s)": "Michael and Sarah Johnson", "Phone": { "Work": "2125554389", "Home": "7185559246" }, "List a second contact": { "Phone": "6465557812", "value": "Emily Carter, aunt" }, "Medical Information": { "Policy #": "739284165", "Group #": "482917", "Insurance Company": "Blue Cross Blue Shield" }, "Insurance is under what name?": "Michael Johnson", "List any medications you are allergic to and/or medical conditions that may be pertinent to the type of medical attention you receive": "Allergic to penicillin; mild asthma treated with an inhaler as needed" }, "Have you ever been convicted of a felony?": "Yes (if yes please explain on separate sheet of paper)", "Date": "15/03/2024", "Applicant Signature": "Michael Anderson", "Sex": "Female" } }