Housing Room Change Request Form

Residents can submit a room change request during the first two weeks of the semester. Room changes are subject to approval by a representative from the Office of Housing & Residence Life, and are not guaranteed.

Any room changes that occur without the approval of an administrator from the Office of Housing & Residence Life may result in disciplinary action.

Name

Student ID Number

Gender

Male

Female

Class Rank

Freshman

Sophomore

Junior

Senior

Cell Phone Number:

SSU Email Address:

Current Building and Room Number

Requested Building and Room Number

Reason for Request

Financial

Building Preference

Roommate Conflict (Provide additional information below)

Other Reason

If Other, Please Explain

If the reason is Roommate Conflict, have you discussed the issue(s) with your Resident Assistant?

Yes

What was the result of your discussion?

By submitting this form, I certify that I understand that if this request is approved, adjustments could be made to my University account, and this could result in either a credit or deficit balance. This amount will be indicated on my student bill. It is my sole responsibility to check my account on MySSU for these changes, and make the needed arrangements to fulfill any remaining balance that my account is charged as a result of this change

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Room Change Request Form