College Houses Checkout Form

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All members are required to complete this form to receive their deposit back. A checkout form should be used anytime a person changes rooms or checks out of their cooperative. The Membership Coordinator or another officer or staff member will verify the information the member provides in this form.

Per our policies, all members will be assessed a cleaning and sanitization fee, as well as possible fees to clean and repair common areas based on their condition at the end of the semester.

House *

21st

Halstead

Laurel

Nueces

Opsis

Pearl

Taos

Do you want to be connected with a group of co-op alumni from your house for staying connected or planning future social events?

Yes

Other:

Clear selection

First Name *

Last Name *

E-mail address *

Phone Number *

Room Number *

What date will you check out and return the keys to the office (1906 Pearl Street)? *

YYYY

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