Exit Interview Form
This form must be filled out by all students leaving the Residence Halls.
Name
Your answer
Current Room Assignment
Your answer
Class Status
Please understand all incoming first year students are required to live in College residence for their first two years, unless residing at home with their legal parent or guardian who live within a 30 mile radius. All transfer students are required to have lived on a campus for 4 semesters. This means incoming second year transfers are required to reside on campus unless residing at home with their legal parent or guardian.
Required
Date leaving the residence halls.
MM
/
DD
/
YYYY
ID#
Your answer
Current Building
Current Room number
Your answer
Reason(s) for leaving the Residence Halls?
Required
Next year you will be attending Utica College:
Are you moving:
What is your approximate overall GPA?
I understand that by selecting "YES" that I do understand I am forgoing a room on campus for this coming academic year.
Submit
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