Check-Out Charges Appeal Form

Please fill in the form below. All Check Out Charge appeals for Fall 2014 semester must be submitted by January 16th 2014 @ 11:59pm EST.

All Check Out Charge appeals for Summer 2014 semester September 4th 2014 @ 11:59pm EST.

NOTE: In order for shared charges to be removed from your account, one of the roommates must take responsibility for the charge.
This can be requested by using this appeal form.

First Name:
Last Name:
Student ID:
Student Email:
Residence Hall:
Room Number:
Charge to be appealed:
Reason for Appeal:
2nd Charge to be appealed(if applicable):
Reason for Appeal: