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Forms
/
Housing Petition
Housing Petition
Name
*
First
Last
Student ID
*
Email
*
Phone
Are you an International Student?
- Select one -
Yes
No
Do you have an F1 Visa?
- Select one -
Yes
No
Do you have a roommate (not spouse)?
- Select one -
Yes
No
Roommate name(s)
All petition requests may be subject to additional charges depending upon the nature of the request (i.e., Campus Service Fee or a 25 percent rental surcharge or both).
Affected Semester and Year
I am requesting permission to
Remain in my housing unit without being enrolled for one semester
Remain in my housing unit while being enrolled in less than the minimum required hours for one semester
Remain in my housing unit beyond the normal fourteen (14) days following graduation
Remain in my housing unit until (date) because my spouse is a teacher in a local school and this will allow him/her to complete the school year.
Remain in my housing unit until (date) because my children are still in school and this will allow them to finish the school year
Remain in my housing unit until (date) which will give me time to complete my mission appointment process. (Please provide a copy of a letter from IMB or NAMB that indicates where you are in the appointment process and the date in which you are expected to complete the process.)
Other
How many hours do you want to take?
Desired move out date
MM slash DD slash YYYY
Please indicate date
MM slash DD slash YYYY
Please provide a copy of a letter from IMB or NAMB that indicates where you are in the appointment process and the date in which you are expected to complete the process
Max. file size: 20 MB.
Reason for request