Office of
Residence Life

Room Change Request Form

Please fill out the form below to file your room change request. Please note that this form is only a request; it is subject to availability and Office approval. If a space meeting your preferences is available and can be offered to you, you will be contacted by your Area Coordinator. Thank you!

* All fields are mandatory

Name of student requesting room change: *

Gender: *

Male

Female

Stevens E-mail: *

Cell #: *

Current room # *

Reason(s) for room change request: *

Requested room change (desired residence hall/room # if known; or list your general preferences): *

Roommate Name *

What is your new requested roommates name?

Roommate Email *

What is your new requested roommate's email address

Office ofResidence Life

Room Change Request Form

Office of
Residence Life