Request to Terminate Student Housing Agreement

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ATTENTION: Please be aware, any and all residents who choose to terminate their Student Housing Agreement before their original set start and end date for any reason other than complete withdrawal from the University, will automatically forfeit their housing deposit on file and remain financially responsible for a prorated amount of the original semester fee dependent upon when the resident terminates their Student Housing Agreement. Residents can find the associated fees in the Student Housing Agreement (Section 4, Letter M).

Name of Resident(Required)

First Last

Student ID Number(Required)

Date to Vacate Housing Assignment

Housing Assignment

(Building/Room #)

Phone Number (day)(Required)

Phone Number (eve)

Email(Required)

Reason for Request to Terminate Student Housing Agreement

Medical

Legal

Familial

Other