Spring Extension of Stay Housing Application First Name Last Name Student ID Cell Phone Number Personal Email Address Date of Birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1917191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 Gender Male Female Residence Room Number Emergency Contact Info First Name Last Name Relationship to you Emergency Contact Phone Number Reason for Extension of Stay Graduation Internship Seminar Other Please CHECK requested dates below: Sunday April 14 Monday April 15 Tuesday April 16 Wednesday April 17 Thursday April 18 Friday April 19 Saturday April 20 Sunday April 21 Monday April 22 Tuesday April 23 Wednesday April 24 Thursday April 25 Friday April 26 Saturday April 27 (Grad) Sunday April 28 Monday April 29 (Internship Seminar) Tuesday April 30 (Internship Seminar) Wednesday May 1 (Internship Seminar) Thursday May 2 Friday May 3 Saturday May 4 Please Note: You are only permitted to live on campus during the approved date (s). TERMS AND CONDITIONS Room Fees: NO CHARGE for Extension of Stay for the purposes of Graduation or Internship Seminar. A cost of $35.00/day or $175.00/week may be charged to your student account dependent on the reason for your extended stay. Campus Services will contact you by email when the application has been processed, enclosing an Individual Residence Booking invoice confirming your check-in and/or check-out dates and fees for Stay. Move-in/Move-out Every attempt will be made to allow you to remain in your current room. Should it be necessary for Campus Services to relocate you, instructions will be given regarding the move. You will complete the 'check-out' procedure for your current room and receive information on your relocation.