ALTERNATE ROOM REQUEST

Note: All Fields are required. 

After submission a copy of this information will be sent to the email address you provided. 

You will then be returned to the Residence Life homepage.

 

Name:

 

 

Email Address:

 

 

Home Phone:                     Cell Phone:

 

 

Building Choices : (Use Ctrl -click to select as many as you wish)

CPA River Terrace Suites Single River Terrace Suites Double Hayden Humphreys Palmer Jonas Hall 733 Jefferson 528 Washington Street

 

Preferred Roommate (Enter 'NA' if None):

 

 

 

Additional Information:

(Enter 'NA' if none)