Off Campus Request Form
Augustana University has a 2 year residency and dining requirement. Student may request for a waiver from the residency requirement under the following circumstances:
- Graduated high school two year prior to the current year
- Are married or have dependents
- Plan to live with a parent or guardian at a local, permanent address provided to AU (60 miles or less)

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Student First Name *
Student Last Name *
ID Number *
What year did you graduate high school? *
Which semester do you intend to begin living off campus? *
Why are you applying to live off campus? *
The information above I have provided is correct. I understand that cancellation of my on-campus housing after June 1st of the contracting year may result in loss of my deposit and a cancellation fee.  *
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