Summer College Night Away Form
**ALL NIGHT AWAY REQUESTS MUST BE APPROVED BY THE REQUESTING PARTICIPANT'S GUARDIAN/PARENTS. SUMMER COLLEGE STAFF WILL CONTACT ALL GUARDIANS/PARENTS TO VERIFY NIGHT AWAY REQUESTS**

Summer College participants must use this form to request a night away from Shaw Hall.
The form must be completed in its entirety two business days before you plan to spend the night away.

Example: if you want to take the night away on Monday, July 9th, this form must be turned in no later than 11:00 PM on Thursday, July 5th.

If you have any questions, please contact Natalie Torres at ntorres@syr.edu

Email address *
Name (First and Last) *
Your answer
Room Number *
Your answer
SUID Number *
Your answer
Date Leaving *
MM
/
DD
/
YYYY
Time Leaving *
Time
:
Where will you be? (Give details - where, and with whom) *
Your answer
Date Returning *
MM
/
DD
/
YYYY
Time Returning *
Time
:
Summer College will contact your guardian/parent to approve this Night Away. Please provide the FULL NAME of your guardian/parent. *
Your answer
Please provide the PHONE NUMBER of your guardian/parent. *
Your answer
Please indicate your agreement with the following statement: "I confirm that the above information regarding my night away request is accurate. I also confirm that my guardian/parent has confirmed my permission to take this night away at the location, date, and time specified above. I also recognize that failure to provide accurate information about my departure or obtain permission from my guardian/parent will result in conduct sanctions from the Summer College staff." *
Required
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