Request Contract Cancel by voe14602

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									                                                                          Return this form to:
                                                                          VCU Central Housing Office
                                                                          Cary & Belvidere Residential College hall
Request to Cancel Housing Contract                                        301 West Cary Street, Richmond, VA 23284
Fall 2009-Spring 2010 and/or Fall 2010-Spring 2011                        Phone: (804) 828-7666    Fax: (804) 828--2466


Check the section below that corresponds with your reason for requesting cancellation of your Fall 2009-Spring 2010
and/or your Fall 2010 - Spring 2011 VCU housing contract. Communications to you from VCU Residential Life &
Housing and the official decision regarding your cancellation request will be sent via the VCU student email system
within 10 - 15 business days; provide your VCU email address below, NOT your personal email address. Please note
that submission of this form does not imply automatic cancellation of your housing contract. Please refer to your contract’s
Terms & Conditions for complete details regarding cancellation policies.


Name ______________________________________________________ VCU Student “V” ID Number _______________________

Permanent Home Address ____________________________________ City, State, Zip ____________________________________

VCU Student Email Address ________________________________ Phone (include Area Code) ___________________________

VCU Housing Assignment (Residence Hall and Room Number) _____________________________________________________

Cancellation date you are requesting _____________________________________________________________________________

    Transferring/withdrawing from VCU at end of Spring 2010 semester; terminating enrollment at VCU. Request
    cancellation of FALL 2010-SPRING 2011 housing contract. Submission of this form does not imply automatic
    cancellation of your housing contract. Refer to the contract’s Terms & Conditions for complete details regarding
    cancellation policies.

    Returning student, continuing enrollment at VCU for 2010-2011. Request cancellation of FALL 2010-SPRING 2011
    housing contract. On this back of this form, or on an attachment, provide circumstances or issues you wish to be
    considered in support of your request to cancel your housing contract. Please write legibly. Submission of
    this form does not imply automatic cancellation of your housing contract. Refer to the contract’s Terms & Conditions
    for complete details regarding cancellation policies.

    New incoming student or returning student new to on-campus housing for 2010-2011. Requesting cancellation of FALL
    2010-SPRING 2011 housing assignment/contract BEFORE June 30, 2010 and refund of $250 housing pre-payment fee.

    New incoming student or returning student new to on-campus housing for Fall 2010-Spring 2011. Requesting
    cancellation of FALL 2010-SPRING 2011 housing assignment/contract AFTER June 30, 2010. On this back of this form,
    or on an attachment, provide circumstances or issues you wish to be considered in support of your request to cancel
    your housing contract. Please write legibly. Submission of this form does not imply automatic cancellation of your
    housing contract. Refer to the contract’s Terms & Conditions for complete details regarding cancellation policies.

    Request cancellation of remainder of FALL 2009-SPRING 2010 housing contract. On this back of this form, or on an
    attachment, provide circumstances or issues you wish to be considered in support of your request to cancel your
    housing contract. Please write legibly. Submission of this form does not imply automatic cancellation of your housing
    ontract. Refer to the contract’s Terms & Conditions for complete details regarding cancellation policies.

    Marriage, Study Abroad or Medical Rotation (circle one). Request cancellation of remainder of Fall 2009-Spring 2010
    housing contract and/or Fall 2010-Spring 2011 housing contract. You must provide a copy of your marriage license or
    documentation from the appropriate University department to be considered for release from your contract. Refer to the
    contract’s Terms & Conditions for complete details regarding cancellation policies.
By signing this form, I confirm that I have fully read and understand the above cancellation policies. I also understand that
submission of this form does not imply automatic cancellation of my housing contract and that I should refer to that contract
for complete details regarding housing cancellation requests.


Student Signature: ________________________________________________ Today’s Date: _________________________

								
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