Processed Date
-
Month
-
Day
Year
Date
Housing Cancellation Form
Please complete the following form to cancel your Housing Application.
Application Year:
*
Application Period:
Summer
Fall-Spring
Spring
Campus
*
Bay Minette
Brewton
Student Name
*
First Name
Last Name
Suffix
Student CA ID #:
*
Phone Number:
*
-
Area Code
Phone Number
Student e-mail:
*
xxx0000@student.coastalalabama.edu
Did you receive a Housing Assignment, or are you on the waiting list?
*
Sun Chief Hall
Thompson Hall
I have not received anything from Housing.
Please choose if you are cancelling your application or requesting to be moved to the Spring Wait List.
*
I want to cancel my Housing Application and be removed from the Housing List.
I want to be moved to the Spring Wait List
Please select a reason for cancelling your application:
*
No longer attending for this semester
No longer attending the College
No longer interested in Campus Housing
Financial reasons
Other
Comments:
Note: The required $100 application fee submitted with the
fall/spring
application is
non-refundable
.
The required $50 application fee submitted with the
summer
application is
non-refundable
.
Before signing this form, please verify that the information you have provided is correct.
Student's Signature:
Electronic Signature:
*
Student Name
Submit
Should be Empty: