College Houses Checkout Form
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.
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House *
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)? *
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