Office of Residence Life -- Housing Agreement Spring Semester Release Form

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This form is only to be completed by Duquesne University resident students who currently reside on campus but will not return to the Living Learning Centers for the 2021 Spring Semester. Returning residents do not need to complete this form as they will be automatically billed for the Spring Semester room and board.

Prior to the end of the fall semester, Thursday, December 10, 2020, Students will be permitted to cancel their room reservation for the spring semester by completing a spring release form. This release from the spring semester portion of the housing agreement will result in removal of spring room and board charges.

Email *

Last name: *

First name: *

Year in school: *

Freshman

Sophomore

Junior

Senior

5th Year

6th Year

Grad

Law

Banner ID Number: *

Starts D0, can be found on a bill in CashNet or your class schedule

Cell phone number: *

Which Living Learning Center do you currently reside? *

Assumption

Des Places

St. Ann East

St. Ann West

St. Martin

Towers A

Towers B

Towers C

Vickroy

Room Number: *

What is your meal plan? *

Block 175

Block 200

Block 225

Block 275

Superplan

What is your Student Mailing Center number? *

4 digits

What is your forwarding address? *

Please include Street, City, State, ZIP

What is your forwarding email? *

Reason for leaving: *

For all reasons below except for Financial Reasons, you will need to email ORL@duq.edu and include an attachment to verify the reason you have selected. If you selected commuting, please email ORL@duq.edu and state where you will be commuting from.

Taking courses remotely

Academic Dismissal

Commuting

December Graduation

Financial Reasons

Internship/Externship

Medical

Student Teaching

Transferring to another university/college

Other:

Required

For the reason selected above, except for Financial Reasons, you will need to email ORL@duq.edu and include an attachment to verify the reason you have selected. If you selected commuting, please email ORL@duq.edu and state where you will be commuting from

Yes I understand.

Clear selection

I understand that by completing this form, I am relinquishing my room in the Duquesne University Living Learning Centers for the 2021 Spring Semester and that all housing charges for the 20201 Spring Semester will be removed from my bill. *

Yes I understand

Required

Please type your name below as a signature to affirm all information entered above. *

A copy of your responses will be emailed to the address you provided.

Submit

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