Residential Life Request for Release and/or Cancellation Form

IMPORTANT NOTE: Please understand this is only a request. There are no guarantees. If you are currently in a contract and living in a room/apartment, it will be highly unlikely you will be released from your contract.
PERSONAL AND CONTACT INFORMATION
Name Name First Last
T-Number (please include letter T and all numbers):
Must be 9 characters. Currently Entered: 0 characters.
Are you at least 18 years old at the time of this request?

Are you at least 18 years old at the time of this request? Yes No
Home Mailing Address Home Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please give your Tennessee Tech email address (you will receive a copy of this request):
Please give a number we can reach you at, preferably a cell phone number: Please give a number we can reach you at, preferably a cell phone number: - ### - ### ####
If you currently live on campus or currently have an assignment, please choose the appropriate hall/location:
REQUEST INFORMATION
Please choose the request period:
Please indicate your reason for requesting cancellation of your application or release from the application/on campus requirement:

Please indicate your reason for requesting cancellation of your application or release from the application/on campus requirement: Not enrolling at Tennessee Tech University (Please immediately drop all classes) Withdrawing from Tennessee Tech University (Please immediately drop all classes) Completed two semesters of college coursework or have minimum of 30 university credit hours Age 21 by the first day of classes for the semester Commuting from a parent and/or legal guardian at their permanent address which is within a 50 mile radius of Tennessee Tech University (Please provide a parent's name and address for verification below) Living with a brother or sister who is enrolled full time at the university - his/her residence must be within a 50 mile radius of Tennessee Tech University (Please provide the sibling's name and address as well as your parent's name and address (if under 18) for verification in the comment space below) Participating in academic internship/co-op program (Please provide a contact name and address for verification in the comment space below) Married (Please provide your completed original marriage license for copying/documentation purposes) Single Parent (Please provide child's/children's birth certificate(s) for copying/documentation purposes) Physical and/or emotional disability verified by a licensed physician NOTE: Students with disabilities must contact and provide the required documentation to the Accessible Education Center. Other (Please provide a brief detailed explanation of your situation in the comment space below)
Parent Name (all documentation will need to match the name you list here): Parent Name (all documentation will need to match the name you list here): First Last
Parent Address (This is also the address you are commuting from): Parent Address (This is also the address you are commuting from):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent Name (Since you are not at least 18 years old, we will need to send letter to parent for approval to commute from sibling's address): Parent Name (Since you are not at least 18 years old, we will need to send letter to parent for approval to commute from sibling's address): First Last
Parent Address (To send letter for approval to commute from sibling's address): Parent Address (To send letter for approval to commute from sibling's address):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Sibling Name (Name of sibling you are living with): Sibling Name (Name of sibling you are living with): First Last
Sibling T-Number (University Identification Number with letter "T" included):
Sibling Address (This is also the address you are commuting from): Sibling Address (This is also the address you are commuting from):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Academic Internship/Co-op Program Contact Name Academic Internship/Co-op Program Contact Name First Last
Academic Internship/Co-op Program Contact Address Academic Internship/Co-op Program Contact Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please give the appropriate support for your selection above:
By submitting this form, you agree and understand the following: (1) the request/cancellation is not guaranteed to be granted; (2) requests are commonly reviewed within 24 to 48 hours but more time may be necessary to receive requested documents/signatures; (3) you will receive notification of a decision via your Tech email address; (4) we may notify by letter or phone calls if we deem necessary; (5) we do not remove any applicable housing holds until a decision is/if approved.
Type the letters you see in the image below.

Residential Life Request for Release and/or Cancellation Form

Residential Life Request for Release and/or Cancellation Form

IMPORTANT NOTE: Please understand this is only a request. There are no guarantees. If you are currently in a contract and living in a room/apartment, it will be highly unlikely you will be released from your contract.

PERSONAL AND CONTACT INFORMATION

REQUEST INFORMATION