Off-Campus Residency Request - Southwestern College

Off-Campus Residency Request

***** IMPORTANT *****
All full-time main-campus students are required to live on campus except those who are married, veterans, twenty-one years old or older AND reached senior status (85+ EARNED credits), or live with their parents or legal guardians (within 50 miles of campus).

Students who are 24 years and older are exempt from residency requirements.

Note: Students moving off-campus are subject to a 40% adjustment of some institutional aid. Please visit with Financial Aid for an off campus estimate and refer to the financial aid handbook:

ALL APPROVED OFF-CAMPUS REQUESTS WILL STAND FOR THE ENTIRE ACADEMIC YEAR.

Student ID Number

Name

First NameLast Name

Cell Phone

Area CodePhone Number

E-mail

Personal Email Address

Birthdate

Date

What class level will you be in the requested year?

Requesting off-Campus for the following academic year

All full time main-campus students (12 hours or more per semester) are required to live on-campus unless they qualify for an exemption. I request to live off-campus for the following reason(s):

If student has been granted an appeal or is living at home with a parent or guardian please provide a parent name and phone number.

(Residence life will be confirming residency with parent/s.)

Off-Campus Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have you met with Financial Aid and received an off campus estimate?

I understand that by moving of campus some of my institutional financial aid is subject to a 40% adjustment.

I certify that the reasons I have given in this application and supporting information is true and accurate to the best of my knowledge. I recognize, if permission is granted, that it is based on my residency at the address given on this application. I must reapply for off-campus residency whenever the information stated changes or is no longer accurate.

Note: Any student supplying false information on an application for off-campus residency or who fails to immediately notify the Office of Student Affairs upon a change in exemption status, with intent to deceive, may be invoiced for room and board and may be subject to a student conduct violation.

Signing below signifies that you have read the application. as well as understand and agree to the terms and conditions stated on this application.

Signature

OLD - NOT USED BUT NEED TO KEEP - Off Campus Address:

(If you do not have your address yet please note that. You can edit this form by a link at the bottom of the confirmation e-mail.)

Please take a selfie to verify identity.

If you have questions, please contact Residence Life at residence.life@sckans.edu.