Part Time Student Residence Request Form
Residency in university housing requires full-time enrollment (minimum of 12 hours for
undergraduates and 6 hours for graduate students). Students who drop below full-time enrollment
may request permission from the Housing & Residence Life Office to maintain residency. Any
policy violation committed by a part-time student may result in removal from housing.
Sign in to Google to save your progress. Learn more
Student's Name:
Student ID #:
Assignment:
Room Number:
By signing below I understand that as a part time student, if you are found responsible of violating any university or university housing policy for not fulfilling the terms and conditions of occupancy as outlined in your lease,  you will be required to immediately move off campus.  The lease buyout may apply. Please sign by entering your student ID number.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Central Arkansas. Report Abuse
Google Forms