Off-Campus Request Form

Residence Life > Off-Campus Request Form

Note: This application is to be used for incoming students only. Current students should complete the application in their Residence account, located here: http://uu-residence.symplicity.com

Do not finalize plans to live off-campus, or release your apartment on-campus, until you have submitted this form (and supporting documents, if applicable) to the Office of Residence Life for review and have received notice that you are approved. Although a student may meet the qualifications, there are no automatic approvals without first submitting an Off-Campus Request form. Off-Campus Requests that do not meet qualifications will be reviewed by the Off-Campus Housing Appeals Committee. The priority deadline for submitting an Off-Campus Request for Fall 2013 is April 15th.

Name
First Last
Student ID
Cell Phone
(ex. xxx-xxx-xxxx)
Birthdate
Current Classification
Anticipated Graduation Date
I am applying to live off-campus because:
I will be living at home with my parent(s) or guardian within a 40-mile radius of Union University. My parent(s) or guardian will verify I will be commuting from home.

Parent or Guardian's Name

Parent or Guardian's Phone Number
(ex. xxx-xxx-xxxx)

I will be at least 22 years old as of the first day of the Fall semester for which I am requesting to live off-campus.
I am getting married before the semester begins.
I am a part-time student taking less than 12 hours this semester.
I have a rare, extreme health condition, and my doctor has written a letter on his office letterhead strongly recommending that I live off-campus.
I have completed four full-time semesters at a different university (New Students Only).
I do not meet any of the above qualifications to move off-campus. I would like the Appeals Committee to review my situation and request to move off-campus. Here are detailed facts concerning my circumstances that I would like the committee to consider.

Please note that only in extreme, extenuating circumstances will an appeal be granted to students who do not meet qualifications.
If I am approved to live off-campus, my address will be:
Apartment Complex (if applicable)

Street Address

City State Zip Code
Name(s) of Future Roommates

Late Request Fees

Incoming Students - If you have paid a housing deposit and are approved to move off-campus, you will be eligible to receive your deposit refund until May 1st. After May 1st, your housing deposit will not be refunded.

Please read the following, and agree below.

Your request will not be processed without indicating your agreement to the terms listed below.

I have been honest in the information provided on this form.
I understand that if approved, the approval only applies to the off-campus location and reasons I have listed on this form and supporting documents. If later I want to apply to live at a different, off-campus location, I understand I must submit a new Off-Campus Request form prior to doing so.
I have read Union's Housing Policy in the Campus Life Handbook and the UU Single-Student Housing Contract. I understand that Union is a residential university and therefore requires all single, full-time, undergraduate students who have less than 86 credits by the beginning of the current academic year to live on-campus. I also understand that my housing contract is for the full academic year and cannot be broken without approval.
I understand that if I am not approved to move off-campus, but choose to do so regardless, I will be required to pay Union University the minimum cost of on-campus housing (found in the Campus Life Handbook) each semester-- until I move back on-campus or have approval to live off-campus.
I understand if I am applying after the deadline of November 15th there will be a late request fee and forfeiture of my housing deposit assessed to my student account.

Checking this box constitutes as my signature and that I agree to all of the terms listed above and certify that all information in this form is true.

I Agree

Residence Life

Residence Life > Off-Campus Request Form