Summer College Overnight/Extended Leave Form
Completion of this form is required for any student who wishes to leave campus for an overnight stay or extended leave during the course of their enrollment. Multiple submissions do not have to be made for consecutive nights, but there must be a submission for each individual trip or stay.
FORMS MUST BE SUBMITTED AT LEAST 72 HOURS PRIOR TO INTENDED DEPARTURE. STUDENTS WILL RECEIVE A CONFIRMATION EMAIL 24-48 HOURS PRIOR TO DEPARTURE. STUDENTS SHOULD BE CHECKING THEIR EMAIL.
Name of Student
Provide Full Name
Your answer
Student Cell Phone Number
Your answer
Student Personal Email Address (not SU email)
Your answer
Summer College Program
List the program of enrollment
Your answer
Room Number
Assigned Room Number in Residence Hall
Your answer
Date & Time of Departure
Your answer
Date & Time of Return
Your answer
Reason for Departure
Please provide a brief explanation so the Summer College Staff can confirm with your guardian(s).
Your answer
Guardian Contact Information
Please provide the name and phone number of your guardian(s), so staff can confirm your leave from campus.
Your answer
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