Intent to Vacate Form
Note:This form must be completed by all students who plan to vacate University housing (for whatever reason) before the end of the semester, at the end of the semester, or end of the academic year. Before vacating please read your Housing Terms of Agreement.
Banner ID (A number):
Do you currently live in the Residence Hall specified above?
Off Campus Address:
Reason For Vacating Campus Housing (pick one)
Moving off Campus
By placing your signature below you are agreeing to the following statement: I, the undersigned, fully understand that I will forfeit/be charged housing fees for the current academic year as stated in the contract for student housing. (Place initials below)
Residence Hall Director (Pick one) Approval required by Hall Director
Natasha Langford-Normal Hills
Malcom Williams-Knight Complex
Brenda Mallard-Hopkins Hall
Tailia Berryhill-Palmer Hall
Henry Davis-Morris Hall
Jacqueline Flowers-Thigpen Hall
Brendalyn Hall-Terry Hall
Synethea Anderson-Foster Complex
Randy Rhynes-Stephens Hall
I am requesting the $250.00 Housing Security Deposit that I have paid because I will no longer reside in university housing. (If there is a balance on your account,the deposit will be applied to the current balance.)
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