Housing Release Request Form Page 2
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2Housing Release Request Form
Name: _________________________________________ Student ID #: __________________
Phone #:__________________ Email: _________________________ Date of Birth: ________
Current Room Assignment: ______________________________________________________
Academic Term for Request
:
Fall
Spring
Summer
Reason for Request
:
Junior or Senior Standing
21 Years of Age
Married, living with spouse
Residing with a relative*
Veteran of US Armed Forces
Residing in Greek housing**
Other (Attach Description)
Financial Need
*Name of Relative:
Relationship:
Address:
Phone #:
** Fraternity:
All documentation requested on reverse must be included to file request. Additional
documentation may be requested. A release from housing is not final until formal approval is
given from the Residence Life Department. The early termination of a housing contract will
result in loss of deposit.
Signature of Student: _________________________________ Date: _____________________
Other/Financial Request
Office Use Only
Met with FA?
Yes
Description Attached?
Yes
Marriage Request
Military Request
Enrollment Request
Relative Request
Fraternity Request
Meeting Set?
Yes
Documents Attached?
Documents Attached?
Transcripts Attached?
Documents Attached?
Documents Attached?
Yes
Yes
Yes
Yes
Yes
Date/Time: ________________
Finance and Administration:
By: _______________________ Date: ________________
Approved
Declined
Revised 5/23/2013
Residence Life Department:
By: _______________________ Date: ________________
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Parent category: Legal