PhilaU - Break Housing Application and Agreement
Office of Residence Life Kanbar Campus Center, Suite 311 215-951-2741
Break Housing Application
Break Housing Fees: Break Housing is billed as a flat fee with approval for the duration of the break even if you do not plan on staying on campus for the full duration. Thanksgiving Break: $100. Spring Break $175.
PhilaU ID Number
Date of Birth
PhilaU Email Address
Current Campus Address
Cell Phone Number
Reason For Request
Primary reason for request:
Permanent address further than 3 hours away from PhilaU
Please describe additional information for request based on the primary reason indicated above.
(If you indicated your reason is for athletics, please indicate which athletic team. If you indicated other, please explain)
Break Housing Space
Please indicate the residence hall and room you are requesting for the break period. If staying in another residents space the Office of Residence Life will contact the host residents and must receive their permission before the break housing request will be approved.
Current Space (only available in Independence Plaza, Townhouse, Falls Center & Ronson Hall)
Break Housing Agreement
Part 1: Criteria for Break Housing You are solely responsible for finding an eligible space on campus to stay. The residents of the space must provide you with permission and keys in order to stay in the space. Eligible spaces are defined as Independence Plaza, Falls Center, Townhouses or Ronson Hall. You must be willing to relocate any belongings you will need during the break prior to the residence halls closing for the break period. Your permanent home address must be more than three hours away from the University in order to request to stay. If approved for break housing, you will be billed a $100 housing fee for Thanksgiving Break and/or a $175 housing fee for Spring Break to your student account. Part 2: Policies & Procedures for Break Housing Only approved Break residents can be signed into buildings as guests. Break residents are not permitted guests. No exceptions. All other policies are in effect for the break period.
I understand that this application is a request only and that approval to stay during the break period is at the sole discretion of the Office of Residence Life. In addition, I have read and accept responsibility for the terms and conditions of my Break Housing Assignment.
By checking the box below, you are accepting responsibility for all terms and conditions.
I understand and accept all terms and conditions above.
Never submit passwords through Google Forms.
Terms of Service