Housing & Residence Life FORM- COVID19

Housing & Residence Life FORM- COVID19
Per the Thursday, 3/19/2020 email sent by President Clark, Southeastern will be moving to online learning format for the duration of the semester. We have made the decision to close the residence halls. Students with extenuating circumstances, which require them to remain in the residence halls for the rest of the semester, must be request authorization to remain on campus by completing this form and submitting it by Tuesday, 3/24/2020.
Name*

First NameLast Name
Which building do you live in?*

Chickasaw HallChoctaw HallNorth HallShearer Hall
Room Number*
Phone Number*

Area CodePhone Number
Reason I am requesting to stay*

No alternate home baseWorkAccess to wifi/devices for learning
Please explain further*
**If you answered "Work" as a reason you will be staying** Where do you work?
*All participants must read and check these boxes.*
More information regarding fees and refunds will be distributed as decisions are made.
Signature*

Clear
Should be Empty: