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| Middle Initial: |
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| Last Name: |
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| Birth Date: |
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| Age: |
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| Sex: |
Male Female |
| Home Address: |
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| City: |
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| State: |
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| Zip: |
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| Home Telephone: |
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| Intended Major: |
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| Email: |
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| Entering as a: |
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Please select a Meal Plan for the semester:
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Unlimited Meals, 2 guest passes & $150 in dining points for $2,100/semester |
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Unlimited Meals & 2 guest passes for $2,000/semester |
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15 Meals per week for $1,790/semester |
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150 Meals & $100 in dining points for $1,225/semester |
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100 Meals + $200 in dining points for $1,000/semester |
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Commuter Lunch, Monday - Friday only, for $390/semester |
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No Meal Plan |
| Off-Campus Address: |
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| Off-Campus Telephone: |
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Please note the following guidelines:
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Simply wanting to live off-campus is not an extenuating circumstance.
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Your request must stand on its own merits. Circumstances involving other students petitions will not be factored into the decision making process.
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DO NOT sign a lease or make any commitments to a landlord before receiving notice of your petition being approved.
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Housing contracts are signed for the full academic year. Therefore, a request for off-campus housing in the spring must demonstrate extreme circumstances, as it requires your binding contract with the College to be broken.
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Once approved to move off-campus, if the student wishes to move back onto campus, a room is not guaranteed. Furthermore, the student will be given the lowest priority to be housed.
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Living with parent/guardian (mail [USPS] letter of permission and a photocopy of his/her drivers license to verify address) |
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Living with spouse and /or children (mail [USPS] marriage or childs birth certificate) |
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Financial hardship (provide a budget) Explain your financial hardship in the text area below. |
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Medical/Health (Explain medical situation below and mail [USPS] a note from your care provider documenting the problem) |
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Other - Please choose one and explain below: |
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| I give permission for University officials to verify my responses and to obtain other relevant information pertaining to my housing. |