Housing Exemptions / Termination Request

Student Information

The �� housing requirement states that students must reside on campus for two years and carry an associated meal plan unless they meet one or more of the exemption criteria outlined below.

Housing contracts are binding for the full academic year, or the remainder thereof, and students are required to fulfill this obligation. Students wishing to request exemption from the housing requirement must provide appropriate documentation to support their request.

For further information on the request and request process visit: .

This is not an accommodation process. For information on how to request an accommodation due to a disability, contact: .

First Name

Last Name

PID

Phone Number

Email Address

Date of Birth

High School Graduation Date

Address

City/Town

State/Province

ZIP/Postal Code

Country

Permanent Home Address

Residential Information

Current Residence Hall Assignment (If Applicable)

Hall & Room #

Address

City/Town

State/Province

ZIP/Postal Code

Proposed New Address

Request Information

Please be aware that requests for housing exemptions based on medical reasons cannot be submitted through this process. If you would like to seek an exemption from housing due to medical reasons, you must register with Accessibility Services. Accessibility Services will assess whether any housing accommodations are necessary and, if so, whether those accommodations can be met through on-campus housing.

Exemption Request Reason

Additional Exemption Request Reason

Other

In five or six words, please describe your exemption request reason. Use the Personal Statement form to provide details.

Academic Year

Requested Term

Upload Additional Documentation

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10 MB limit.
Allowed types: jpg, jpeg, png, pdf, doc, docx, xls, xlsx, zip.

Certification

I agree that my request for exemption/termination will not be processed until all required forms and documentation have been submitted as listed on the exemption/termination webpage.

I certify that my reasons for making this request are true and understand that falsification of any materials submitted in support of this exemption request is a violation of the Student Code of Conduct.

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