New Resident Agreement Termination Request Form
We're so sorry that you won't be joining us this coming year! Please review and complete this form and submit your cancellation fee accordingly.
Section 22.b - Prior to the Starting Date, you may terminate this Agreement if you do not meet at least one of the eligibility criteria set forth in Section 1, provided you (i) notify us in writing at least forty-five (45) days prior to the Starting Date, and pay to us a Termination Fee in the amount of $250.00, or (ii) notify us in writing less than forty-five (45) days prior to the Starting Date, and pay us a Termination Fee in the amount of $500.00. Security Deposit may be held for any termination fees. Please allow 5 - 10 business days for processing. A member of the Daumier Team will follow up with your request via email.
Name
*
Email
*
Phone
*
Reason for termination
*
Please Select
Graduation
Military Activation
Rotations
different housing arrangements
Admission was rescinded.
Financial hardship
Withdrawing from WesternU
Medical hardship
No Longer Planning to Attend WesternU
Other*
Contract Type
*
Please Select
Studio
1 Bedroom
2 Bed Base
2 Bed Deluxe
If other, please add reason
*
Please Upload Supporting Documentation (Letter/email of withdrawal, non-acceptance, etc.)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I have read and understand the terms of termination outline in the Occupancy Agreement.
*
I acknowledge
I understand that if my move out termination request is approved, I am subject to the cancellation fees listed in my Occupancy Agreement.
*
I acknowledge
I understand that submission of this Termination request does not guarantee that I will be granted a release from my Occupancy Agreement.
*
I acknowledge
I understand that if my request is not approved, I will be responsible for all remaining charges and agreement fees.
*
I acknowledge
Signature
*
SUBMIT FORM
Should be Empty: