Current Guest Information University Host Department Contact Information Dining Information Complete Type of Guest Housing Requested: Required Academic Year Guest Housing Summer Guest Housing Guest Name Required Title Title - None - Miss Ms Mr Mrs Dr Other… Enter other… First Required Last Required Suffix Address Required Address Address 2 City/Town State/Province - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code Country - None - Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua & Barbuda Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia & Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Caribbean Netherlands Cayman Islands Central African Republic Ceuta & Melilla Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo - Brazzaville Congo - Kinshasa Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czechia Côte d’Ivoire Denmark Diego Garcia Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard & McDonald Islands Honduras Hong Kong SAR China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR China Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands North Korea North Macedonia Norway Oman Outlying Oceania Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Samoa San Marino Sark Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & South Sandwich Islands South Korea South Sudan Spain Sri Lanka St. Barthélemy St. Helena St. Kitts & Nevis St. Lucia St. Martin St. Pierre & Miquelon St. Vincent & Grenadines Sudan Suriname Svalbard & Jan Mayen Sweden Switzerland Syria São Tomé & Príncipe Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad & Tobago Tristan da Cunha Tunisia Turkmenistan Turks & Caicos Islands Tuvalu Türkiye U.S. Outlying Islands U.S. Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis & Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Phone Required E-mail Required Date of Birth Required Gender Required Reason for Visit Required Special Accommodations (if applicable): Required Are you currently affiliated with the university as staff, faculty, or student? Required Yes No Parking permit needed (summer only) Required Yes We can provide visitor surface parking permits to guests staying in University Suites, but cannot provide them to guests who are staying in Selleck, faculty, staff, or students at UNL. If you are faculty, staff, or a student, please contact Parking Services directly to arrange for a permit. No Arrival Date and Time Required Arrival Date and Time: Date Required Arrival Date and Time: Time Required Departure Date and Time Required Departure Date and Time: Date Required Departure Date and Time: Time Required Room Type Preference Required Please indicate your preference of a double or single room. Double rooms feature two beds, and requesting a double may result in you being placed with a roommate. Single occupancy bedrooms are available at a higher rate. All University Suites rooms are part of a larger apartment unit, with a shared living area, bathroom, and kitchen. All Selleck rooms will have a communal bathroom on the residence hall floor. Double Room Single Room Payment Information Required Guest will pay via credit card prior to arrival Host department will pay for all costs with Cost Object Center Number Guests would like the charges added to their University Consolidated bill Cost Object Center Number (if applicable): NUID Number (if applicable): Additional Notes Please include any additional information about your stay (additional guests on this reservation, roommate requests, etc.). Leave this field blank