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Extendedstayform2014

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Extended Stay Form
First Name
Last Name
T#
Reason for Stay
Current Residence
Hall
Nights to stay Dec. 16 Dec. 17 Dec.18 Dec. 19
Dec. 20 Dec. 21 Dec. 22 Dec. 23
Dec. 24 Dec. 25 Dec. 26 Dec. 27
Dec. 28 Dec. 29 Dec. 30 Dec. 31
Jan. 1 Jan. 2 Jan. 3 Jan. 4
Jan. 5 Jan. 6 Jan. 7 Jan. 8
Jan. 9 Jan. 10 Jan. 11
Please note you will be charged for any nights selected whether you occupy the space or not. If you
swipe into the building on any day not selected you will be charged unless you have specific
permission from the Office of Residence Life. If you notify the Office of Residence Life before
December 16, 2014 with a change or cancellation, it will be honored. The nightly rates are as
follows:
Brown, Critz, Hughes, Turner, Wilson = $13.32/night
Caraway = $14.17/night
Jones, Roush, Tucker = $15.07/night
Baswell, M Street, Nutt, Paine, South, Stadium Suites, Vista Place = $18.11
Baswell
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Extendedstayform2014

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Completed 12 February 2020

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