HOUSING & FOOD SERVICE CHANGE FORM
Student Name: _______________________________________
Student ID Number: __________________________________
TO BE COMPLETED BY RESIDENCE LIFE:
Change Due To:
Current Assignment Requested Assignment
& Meal Plan
& Meal Plan
Effective Date of Hall Change: ______________ Residence Life Approval _____________________________
To Be Completed by Student Accounts Office:
Last Board Access: _____________
Total Meals Used This Semester: __________
Total DCB Dollars Used: _______________
Effective Date of Meal Change: _______________
Student Accounts Approval: _________________________ Student Signature _____________________________
To Be Completed by Office
of Administrative Services
Adjustments to be made to Student Account:
Adjustment
Subcode Amount Debit/(Credit)
Hall Credit _ ______ _ ______ _ __________
Hall Charge _ ______ _ ______ _ __________
Meal Credit _______ _______ ___________
Meal Charge _ ______ _ ______ _ __________
Director of Administrative Services Approval ______________________________
