Housing Agreement Release Request Splash ID#: * Tulane Email: * Cell Phone: * Building: * - Select -Aron ApartmentsButler HallDécou-Labat ResidencesGreenbaum HallGreen Wave HallIrby HallJosephine Louise HallMayer HallMonroe Hall*Not ApplicablePaterson HallPhelps HallSharp HallWall HallWarren HallWeatherhead Hall Please choose the building your room assignment is in for the term you wish to request release from the Housing Agreement. If you do not have a housing assignment from the current term, please select 'not applicable' Room: * Please enter the room number for the term you wish to request release from the Housing Agreement. If you do not have a housing assignment for the term you wish to request release, please type 'not applicable' or 'N/A' First: * Last: * The Residence Hall Housing Agreement is binding for the entire academic year. This Agreement is strictly adhered to with exceptions made under special circumstances. Students who wish to request a release may do so by completing the Housing Agreement Release Request form and submitting it to the department of Housing and Residence Life. Submitting a request for a release does not guarantee release nor should acceptance of the request by the department of Housing and Residence Life be construed as a commitment to release. Residents requesting a Residence Hall Housing Agreement release must provide written documentation that a significant, uncontrollable, and unforeseen change in circumstance has occurred, since the time the Agreement was signed, which has created a special housing need that cannot be provided by the department of Housing and Residence Life. The Process for Requesting a Release 1. Resident must obtain, complete, and submit a Housing Agreement Release Request to Housing and Residence Life. 2. Depending on the reason for the release request, the resident must also provide a written letter outlining the following: - The reason(s) for requesting a Housing Agreement Release Request. - The change in circumstance that prevents the resident from living in on campus housing. - How the resident's housing needs cannot be accommodated through on campus housing. The request will be reviewed by Housing and Residence Life and a decision will be communicated to the resident via Tulane e-mail within 7-10 business days. Reason Documentation Required Mid-year Graduation Completion of the Housing Agreement Release Request Form Study Abroad Completion of the Housing Agreement Release Request Form Withdrawal/Leave of Absence Completion of the Housing Agreement Release Request Form Other: Completion of the Housing Agreement Release Request Form and provide a written letter outlining the reason(s) for requesting a Housing Agreement Release Request, the change in circumstance that prevents the resident from living in on campus housing, and how the resident's housing needs cannot be accommodated through on campus housing. Note: Requests will be processed when supporting documentation is received from campus partners, if applicable. Departure Date: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Additional Documentation Please use this to upload additional information. DO NOT upload medical documentation. Housing and Residence Life does not accept medical documentation and does not approve housing exemptions on medical basis. Students that need housing accommodations due to medical disabilities need to complete the Housing Accommodations process through the Goldman Center for Student Accessibility found here: https://accessibility.tulane.edu/special-housing-accommodations Additional Documentation, if applicable Files must be less than 2 MB.Allowed file types: gif jpg jpeg png. Requested Term for Release Request: * Fall 2022 Spring 2023 Summer 2023 Fall 2023 Reason for Release Request: * Mid-year Graduation Study Abroad Withdrawal/Leave of Absence Transferring Off Campus Remote Study Other Signing and submitting this form signifies that you have read and understand and agree with all information on this form. I understand that: I am responsible for the terms and conditions of my signed Residence Hall License Agreement. I am aware that the Residence Hall License Agreement is binding for the entire academic year. By completing and signing this Agreement Release Request, I am stating that I have read and understood the Agreement Release Guidelines, I wish to have my on-campus housing assignment cancelled, and I wish to be released from my responsibility from my Residence Hall License Agreement. I am aware that submitting this request does not guarantee that I will be released from my Residence Hall License Agreement. If my request for release is not approved, a space on-campus will be reserved for me and I will remain responsible for all housing charges. I understand that if I am approved for release, I will be charged in accordance with my Residence Hall License Agreement and am responsible for the associated fees and charges outlined therein. Signature: *
