Fillable University Residency Requirement Exemption Request printable pdf download

Residential Living

Return form to:

UNIVERSITY RESIDENCY REQUIREMENT

EXEMPTION REQUEST

The Office of Residential Living

WTAMU Box 60878

___________

For Office Use Only:

Approved

Denied

Canyon, Texas 79016

t 806 651 3000 f 806 651 3010

Date_________________

Initials__________

Code___________

housing@wtamu.edu

Comments_________________________________________________________________________

NOTE:

Students should not sign contracts for off-campus housing until they receive formal approval for an exemption.

WTAMU’s Housing Agreement is valid for one full academic year; a student who is currently under a housing agreement, and

submits this form after the day of move-in of the Fall semester, will be denied an exemption.

Exceptions to the housing requirement will be made for students who provide the indicated documentation along with this form and are found eligible. In

order to be considered for this exemption, the student must complete and submit the required documentation to the Office of Residential Living no later

than August 1

. If the student is admitted to the University after this deadline, exemption requests will be accepted up to the first class day. After

these deadlines, no exemptions will be approved. Incomplete requests that do not have all of the required documentation and/or information

will not be reviewed. For more details on the requirement, visit our Housing and Meal Plan Requirements link at wtamu.edu/residentialliving.

Please Print or Type:

Semester / Year that I am applying for:

Fall 20_____ / Spring 20_____

Student Name:

Buff ID:

WT Email*:

Cell Phone:

*Response to requests will be made to WT Student Email Address.

I acknowledge that submission of this form DOES NOT guarantee approval of my request. I understand that this is a sworn statement

to the State of Texas and affirm that all the information herein and attached is correct and factual to the best of my knowledge. I also

understand that if this exemption request is not granted or is revoked, I will be responsible for charges to my University account

for a room and/or meals. Any form of misrepresentation on this form may constitute “Falsification of Records” which is a violation of

University rules and is punishable through the University’s judicial system.

Student Signature

Date

Check

Exemption Type

Required Documentation To Be Submitted With This Form

Reason

Proof of age or transcript copies showing completion of 60 post-high school

Age/Hours –

Student will reach 21 years of age prior to

credit hours. Students who have lived on-campus at another university must

September 1 or will have accumulated at least 60 post-high

provide documented proof of such (i.e. letter on official letterhead with dates

school credit hours prior to the first class day or lived on-

of residency from previous college, official email from housing office w/ dates).

campus for two academic years at WT or another university.

Copy of the student's class schedule for the semester. Please note: this

Part-Time Status or Online-Only Classes –

Student

exemption is only valid for ONE semester.

registers for and maintains less than 12 credit hours per

semester or will only be taking online classes.

1) Copies of a state-issued ID for the parent/legal guardian and student

Living with Parents –

Student will live with parent/legal

2) Notarized letter (notary form available through Residential Living) signed by

guardian at the permanent address of record within a 50-

parent/legal guardian and student stating they will be living at home (include

mile radius of the University.

address) with the parent/legal guardian whose permanent address is within

a 50-mile radius of the University.

Financial Reasons –

1) Student has completed and submitted the Free Application for Federal

Student has experienced a significant

Student Aid (FAFSA) to the WTAMU Financial Aid Office (please note it can

change in financial resources AND exhausted all of their

take a few weeks before the University receives the FAFSA information);

financial resources. Student GPA and attempted hours will

2) Letter outlining significant financial change, as well as any documentation

also be taken into consideration.

that may support this exemption request. Also indicate the number of

Please note: This exemption will not be considered if a student

immediate family members in college for the year/semester applying for.

eligible for loans through the FAFSA chooses to decline those loans.

Financial savings is not a valid reason for this exemption type.

Marriage/Dependent Child –

A copy of the student's marriage license/certificate or a copy of the dependent

Student who is currently

child's birth certificate.

married or has dependent children under their care.

Medical –

The following information should be provided by a physician and attached to

Student has a documented medical disability that

this form on official letterhead and be legible, signed, dated, and verifiable:

drastically affects the student's ability to live on-campus and

• A medical or clinical diagnosis (within 60 days) of the disability by a licensed

requires accommodations which the University cannot

professional in the appropriate area of specialization, clearly defining the

provide.

impact of the disability on the student’s housing needs.

• Observations or recommendations of accommodations that would assist the

Please note: WTAMU can provide on-campus housing that

Office of Residential Living in serving the student. Recommended

meets most medical needs; requests for residing off campus

accommodations must be directly related to the disability.

due to allergies/asthma are typically not approved.

• If applicable, a student with a documented disability must be registered with

Student Disability Services.

Please note that exemption processing takes a minimum of three (3) weeks, assuming adequate information is submitted.

University Residency Requirement Exemption Request

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