Dormitory Request Form

PRCC Dormitory Request



Below is a request form for room reservations for participants in your summer camps/conferences. Our office will notify you when your dates are approved so you may begin advertising for your camp/conference. We advise you not to spend money on publishing material for advertisement until your dates are approved. The below request form for residence hall rooms will be prioritized by the date received. Each participant and/or guest must be at least 12 years of age to stay in the residence halls. The housing cost for summer 2023 is $5.00 per person for each night. If you have any questions, please feel free to contact Jason Francis at 601-403-1276. We look forward to assisting you with your camps/conferences. If you are interested in Aladdin Food Services, please contact Jerome Wilson at 601-403-1322.

Contact Information:

Camp/Conference Dates:

Student/Chaperone Information:


Pearl River Community College will not be held responsible for damages to the dormitory/campus during your conference/camp. Your school/group will be held liable and expected to cover the damage costs. On the last day of your camp/conference, an inspection of the dormitory will be conducted by the head resident. If there are damages, you will receive a notice which will include the damage description and cost.

My typed name above will serve as my signature to acknowledge that I have read and understand the PRCC Dormitory Request Form.

Each community college president is asked to bring two (2) wrapped door prizes, minimum value of $50 each. We will have a station set up at the conference for you to drop off the door prizes.

Each community college is asked to provide name tags for their Board members, administration, and staff attending the conference.