REQUEST FOR EXEMPTION FROM UNIVERSITY AFFILIATED HOUSING
Please read this form thoroughly before submitting request. The housing requirement has been implemented for the following
purposes: a) support student academic success; b) enhance student development; and c) assist students in making a smooth
transition to university life. An exemption request is only considered when a student has not signed up for housing, but is seeking to
be exempt from the University Housing Requirement. If you have already submitted a completed housing application and would like
to be released from your housing agreement, you need to fill out a “Contract Release Request”.
HOUSING REQUIREMENT: All incoming full-time undergraduate students who are first time in college or a transfer student who is
transferring less than 24 credits from a previous institution are required to live in university affiliated housing for their freshman
and sophomore year (or their first four semesters of enrollment at Clarion). On campus housing is considered to be the Hilltop
Suites, Suites on Main or Reinhard Villages.
Requests will be reviewed by the appropriate personnel and a decision will be communicated in writing within 10 days of receipt of
request. Please note – ALL DECISIONS ARE FINAL.
This form must be completed each year and an exemption is not guaranteed from year to year.
Select your exemption request reason: (Further documentation may be requested for verification)
___ First time in college students or transfers who are living with a parent or guardian at their permanent address within
a 30 mile radius of the Clarion University address of 840 Wood Street, Clarion, PA 16214.
___ A full-time transfer student with more than 24 credits from a previous institution.
___ Married students.
___ Students over the age of 21.
___ Part time students – Registered for less than 12 credits.
___ Parent of a dependent child.
___Taking all online courses.
___ Military veterans who have been honorably discharged and can verify their status with an official DD214 form.
___ If a Freshmen at the end of their second semester (must meet all three of these):
Has earned a 3.9 GPA or higher their first semester with a schedule of at least 15 earned credits
Is in good standing with the university (no debt to the university/ no discipline action)
Is active elsewhere on campus (belongs to one or more student organizations; participated in one or more HIPS)
_________________________________ _____________________________ _____ __________________________
Last Name First Name MI ID Number
_________________________________ _____________________________ ________________________________
Date of Birth Cell Phone # Clarion Email Address
______________________________________________________________________ __________________________
Permanent Mailing Address City State Zip Home Phone #
Exemption Request for (please circle all that apply): Academic Year _______________
Year
Please type your name for your signature : _______________________________________ Date: ____________
_____________________
Students requesting an exemption to the housing requirement must complete this form and submit it to the Office of Residence Life
Services, Clarion University of Pennsylvania, 840 Wood Street – 218 Becht Hall, Clarion, PA 16214.
Please download the form onto your computer, fill the form out, and save it onto your computer. Email the completed form
back to reslife@clarion.edu
Updated May 2020
Residence Life Services
218 Becht Hall
814-393-2352
reslife@clarion.edu
FOR OFFICE USE ONLY: Approved Denied Pending
Reviewer’s Comments: ________________________________________________________________________________________
GPA: ___________________ Initials of Reviewer: _______________
