Off Campus Housing Request Personal InformationName* First Last Maiden Email Address*Phone*Date of Birth* Month Day Year Class in School* Senior Junior Sophomore Freshman Enrollment Status* First-time Freshman Returning Student Former Student (not enrolled for previous semester) Dorm Room*Last Semester Enrolled*Have you previously been approved to live off campus?* Yes No If yes, reason for previous exemptionAddress if approved to live off campus Street Address City State / Province / Region ZIP / Postal Code What academic year are you requesting this exemption for?*Off-Campus HousingReason for Exemption*Students must reside on campus unless they meet one of the following requirements: Married Living locally with member of his/her immediate family (parents, grandparents, adult sibling at least 25 years of age) Completed 100 credit hours Total academic load for a given semester is less than 9 hours Military veteran of more than one (1) year 23 years or older before the fall semester Family Member’s name with whom I will be residing:*Family Member's Phone*Family Member’s relationship to student:* Parent Grandparent Adult Sibling Any additional information you believe is necessary to include about your request?Consent*I agree that all the information here is accurate and correct. I understand that off campus requirements are taken seriously. Noncompliance is cause for dismissal. I understand that I must request a new exemption and be approved each year. I agreeCAPTCHA
