Donate
Policy Wiki
Request Maintenance
Pay Charges

About Us
Housing
Members
Education & Training
SHC Community
- Pine Press
Alumni
- Update Your Contact Information
- Make a Gift
Contact Us

Category: Form Post

Post used for embedded Gravity Forms

Share Return
This form is filled out by a member who does not have any future contracts with the ICC. This is not for ICPSR, Global Reach, CUFE, or CUEB members.
Step 1 of 5

Shares are returned twice a year based on the last contract period during which the member had a contract.

Fall/Winter shares are returned by the end of the following October and Spring/Summer shares are returned by the end of the following March.

Please keep in mind we are a cooperative and delays may occur due to labor shortages and staffing changes.

Name
First Last
Email

House Name
Last Contract Term
Last Contract Year

Save and Continue Later

Mailing Address
Currently, all members within the USA recieve a check. Where would you like your rebate and/or share return to be sent?

Street Address Address Line 2 City State ZIP Code

Paypal Address
Currently, all international student & non-students shares can only be returned via Paypal. What is your Paypal address?

Phone Number
If there are any issues with the postal service or your address, how can we reach you by phone?

Save and Continue Later

Early Share Return Eligibility
Standing Rule 5.1.7 outlines four criteria for recieving a share return outside of the standard two times a year.

I was released from my contract and never lived in a co-op

I’m returning home outside of the United States

I’m leaving the country for a period of more than six months

I had a non-standard contract (less than 4 months)
Date you are leaving the USA
Month
Day
Year
Where will you be moving to?
House Rebates & Assessments
I understand that if I receive an Early Share Return, I am not eligible for a rebate nor will I be charged an assessment

Save and Continue Later

Alumni Information
We maintain a database of former co-opers. We use this information for our mailing list which is for ICC events, the Alumni Cooperator, and house specific events or reunions. We will never sell or give your information to anyone outside of ICC members, alumni/ae, or staff. Let us know how you want to continue your involvement with us and the cooperative movement.

Permanent Address
Where should we send any Alumni information?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shares Donation

I don’t want to donate at this time

I’d like to donate my shares

I’d like to donate all of my shares, rebates, and remaining balance
Donation Applied to
A.K. Stevens Development Fund: capital improvements for the co-ops

Martin Luther King Jr. (MLK) Scholarship Fund: reduced charges for members facing financial difficulties

Luther and Joan Buchele Sustainability Fund: energy efficient improvements for the co-ops

Alumni Program: to sustain the efforts of community amongst our vast alumni co-opers

A.K. Stevens Development Fund
MLK Scholarship Fund
Luther and Joan Buchele Sustainability Fund
Alumni Program
Donation Amount
If you'd like to donate to multiple funds please note in this box. If you're unsure of amounts please note so here and someone from the Finance Department will reach out for follow-up.

Save and Continue Later

Exit Survey
We appreciate your input and ideas, please answer the following short questions

Are you
Graduating and moving out of Ann Arbor
Moving to a private apartment
Moving to a small house
Other (specify)
Other (specify)
Would you recommend the ICC to others?
Would you recommend your ICC HOUSE to others?
Recommendation comments
What was the best part about living in an ICC co-op?
Do you have any suggestions for improving the ICC cooperatives?

Save and Continue Later
August 23, 2017
Scholarship Application
Step 1 of 6

Dear Scholarship Applicant,

All applicants are expected to complete the entire application and provide the Finance Committee with the documentation before your application can be processed. A few special notes:

All applicants are expected to have applied to the Financial Aid Office of the University/College they are attending.

1. If you have been given financial aid, we will ONLY need a copy of your most recent Accept/Decline (A/D) Statement.

2. If you have not applied to the OFA, or have been refused financial aid, please explain the reasons why in a short cover letter.

Extenuating Circumstances. Please explain any extenuating circumstances that impact your financial need status and that you would like the Finance Committee to know about. Address this in your own cover letter at the end of the application.

Document Uploads. To assist in effiency and complete applications, most upload fields are required. If you do not have the information requested attach a blank document stating so.

Final Decision. All award decisions will be made by the Finance Committee. All recipients will be notified by email shortly thereafter. All questions may be directed to the Finance Committee.

Save and Continue Later

Name
First Last
Email

Submission Date*
MM slash DD slash YYYY

House
current or desired

Suite & Room Number
Escher only

Permanent Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone
Term(s) for which you are applying:*
Fall / Winter 2019/2020
Fall Only 2019
Winter Only 2020
Length of the ICC contract for which you are seeking scholarship funds*
4 months
8 months
Student ID Number
if you're a non-student type that into the field

Proof of Student Status
please attach a copy of your current class schedule. If you are a graduate student with no current class schedule, we must have a letter from your department on letterhead verifying that you are an active participant in a grad program. If you are an international student, please also enclose a copy of your I- 20 form.

Drop files here or

Max. file size: 512 MB.

Years spent as a student

Save and Continue Later

Expenses
Tuition & Fees
per semester

Tuition & Fees*
please attach a University/College account statement that is dated after the class drop/add deadline. No estimated statements will be accepted, we need to see the actual current invoice amount.

Drop files here or

Max. file size: 512 MB.

Books & Supplies
This category does not include class fees or computer expenses

Books & Supplies
please attach itemized receipts

Drop files here or

Max. file size: 512 MB.

Room & Board
per month combined House & ICC Charges

Medical
Out of Pocket, this includes doctor bills, prescription costs, insurance premiums which you pay

Medical Itemized
Please include copies of bills and/or doctor verification

Drop files here or

Max. file size: 512 MB.

Educational Related Expenses
Expenses directly related to the completion of your education

Other Mandatory Expenses
Expenses you are legally obligated to pay, although not directly related to the completion of your education. An example would be court-ordered child support payments.

Current Student Debt
Only include debt accrued as a student

Save and Continue Later

Loans: For each loan, include the amount you are borrowing for the academic term(s) in which you will live in the ICC and the loan’s interest rate. Write the total loan amount for the contract period, not the amount disbursed each semester.

Loans
Private Loan
Parent PLUS Loan
Unsubsidized Loan
Subsidized Loan
Private Loan Total
Private Loan Interest Rate
Parent PLUS Loan Total
Parent PLUS Loan Interest Rate
Unsubsidized Loan Total
Unsubsidized Loan Interest Rate
Subsidized Loan Total
Subsidized Loan Interest Rate
Other Loans
total for contract period

Save and Continue Later

Income
What is your hourly wage or equivalent?
How many hours do you work per week?
If applicable, do you feel that you have enough hours or too many hours? Please explain in your attached Extuenuating Circumstances Cover Letter.

Pay Stub*
please attach a copy of your most recent W2 form and a recent pay stub. We would like to assess your income in a fair manner in order to appropriately distribute scholarship funds. If you are an international student attending school on an F1 visa, you must include a copy of your Form I-20.

Drop files here or

Max. file size: 512 MB.

Do you receive tuition coverage from the Kalamazoo Promise or a Michigan Education Trust (MET) account?

Yes

No
Amount of tuition coverage
Scholarship & Grants
total for contract period

Award Letter*
please attach an award letter from your scholarship or grant

Max. file size: 512 MB.

Please have your guardian email vp.finance@icc.coop or dfs@icc.coop a letter detailing the financial support given.

Student Contribution
Savings and Trust, total for contract period

Save and Continue Later

Extenuating Circumstances Cover Letter*
Please attach a letter explaining any extenuating circumstances that impact your financial need status that you would like the Finance Committee to know about.

Max. file size: 512 MB.

Submission Verification
I certify that all statements relating to this application to be correct to the best of my knowledge. I will inform the ICC Finance Committee of any changes in my financial situation.

Save and Continue Later
August 23, 2017
Non-Student Approval
This is the form you fill out if you are not a student but are applying for membership with the ICC. The house receives this information and votes on whether or not to approve a non-student for house membership.
Step 1 of 7

Name
First Last
Email

Submission date
MM slash DD slash YYYY

House

Save and Continue Later

Student status
During contract period or if Spring/Summer for the following Fall

Contract period(s)
Spring/Winter 2017-2018
Spring/Winter 2018-2019
Spring/Winter 2019-2020
Why do you want to move into in the co-ops?

Save and Continue Later

Current Residence
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number
Living situation
Landlord's name
or resident advisor, house president, etc.

First Last
Landlord's phone number
May we call this person for a reference?

Yes

No

Save and Continue Later

Previous Residence
Address 1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Length of residence
Landlord's name
or resident advisor, house president, etc.

First Last
Landlord's phone number
May we call this person for a reference?

Yes

No
Address 2
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Length of residence
Landlord's name
or resident advisor, house president, etc.

First Last
Landlord's phone number
May we call this person for a reference?

Yes

No

Save and Continue Later

Financial support
Please indicate your source(s) of financial support for the period of your intended contract (check all that apply)

Family
Employment
Other
Specify "other" financial support

Save and Continue Later

Present Employment
Position or title
Company
Hours per week
Rate of pay

per hour

annually
Dates of employment
Supervisors name
First Last
Supervisor's phone number
May we call this person for a reference?

Yes

No
Second Job or Previous Employment
Position or title
Company
Hours per week
Rate of pay

per hour

annually
Dates of employment
Supervisors name
First Last
Supervisor's phone number
May we call this person for a reference?

Yes

No

Save and Continue Later

Please write any other information you feel is important:
By submitting this form, I hereby authorize and permit the Inter-Cooperative Council to perform a background check to obtain information about me from law enforcement and/or credit agencies, courthouses, personal, professional and residential referenfences and employers. I also authorize and give permission for all such parties to disclose any information requested about me to the Inter-Cooperative Council.

Save and Continue Later
August 23, 2017
Amenities Reimbursement Form
This is the form filled out every month by the house treasurer for any house amenities expenses that have already been paid for.
Attach the receipts or you will not be reimbursed. Do not list anything except amenities. List all the items separately and with as much information as possible. Amenities reimbursement is available ONLY for items your house approves. Minutes from your house meeting approving the expenditures must be attached.

House Name
Contract Period
Requested By
First Last
For
MM slash DD slash YYYY

Attach the receipts or you will not be reimbursed. Do not list anything except amenities.

List all the items separately and with as much information as possible. Amenities reimbursement is available ONLY for items your house approves. Minutes from your house meeting approving the expenditures must be attached.

Item
Date of Purchase
MM slash DD slash YYYY

Business where item was purchased
Maintenance Amount
Amount

Save and Continue Later
August 23, 2017
House Charges Release

August 15, 2017
Pet Approval 2: House Vote
This is the second form in the pet approval process. It is filled out by house leaders after the house has voted on a pet approval.
House Officer Responsible*
Preferably the House President
First Last
Email

Date*
YYYY dash MM dash DD

House*
Member Seeking Pet Approval*
Current OR Potential Member
First Last
House Vote Results*
Please attach the house meeting minutes document outlining the house vote on the pet in question. 85% House approval needed.

Max. file size: 512 MB.
August 15, 2017

←Previous Page

1 2 3

SHC Office Hours
Monday – Friday, 10am – 5pm

Campus Town Mall
541 E. Grand River Ave., East Lansing, MI 48823

(517) 355-8313 ph | (517) 355-9576 fax
Send a Message | Request Maintenance Support

Facebook
X
Instagram

Search

Search

Spartan Housing Cooperative

© 2026