Fall 2020 Residential Life Express Check-out Form

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This form is for residents who have completely checked out of their space (no items remaining in the room/suite/apartment).

This form should only be submitted once you have no belongings left in my room/suite/apartment and do not intend to return. By acknowledging below, and by completing and submitting this form, you acknowledge that you have checked out of your space. *

I acknowledge that I have moved out all of my belongings and vacated my space.

UMBC ID # *

First Name *

Last Name *

Checkout Date *

Please enter the date in which you completely removed all personal items for your space.

YYYY

Building *

Room Number *

Examples: Harbor 244B= 244B; HSD WIC23A= WIC23A; PAT 251= 251

Mail Forwarding Address (street) *

Mail Forwarding Address (town/city) *

Mail Forwarding Address (state) *

Mail Forwarding Address (zip code) *

Phone Number (don't forget the area code) *

What is your reason for checking out? *

Living elsewhere on campus

Withdrawing from UMBC

Transfer to another college/university

Commuting from Home // Moving Off-Campus

Becoming a part-time student

Graduation

Study Abroad

Returning to Residential Life

Other:

By submitting this form, I understand that my room will be checked soon after the form is submitted. I accept any and all responsibility for the condition of my room, including, but not limited to abandoned property, damage, trash, and/or missing items. *

I understand and accept

Do not submit this form unless you have vacated your space. *

I have vacated my apartment prior to filling out this form.

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