SINGLE ROOM REQUEST FORM
Name Gender Class
Current Hall Assignment
Email
Hall Choices for 09-10: 1)
2)
3)
Are you willing to move to an alternate residence hall to get a single room?
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Please let us know the specific circumstances you believe warrant an assignment to a
single room. If you have a medical or psychological reason, a doctor’s written
verification would be useful. Please complete this form and return it with your Residence
Hall Contract at the Housing Lottery on Thursday, April 9, 2009. Please note that
singles are awarded based on seniority and special circumstances. Lottery numbers for
single rooms will be used when two or more students “competing” for a single room
have similar seniority and situations. Completion of this form does not guarantee an
assignment to a single room.
OFFICE OF CAMPUS LIVING
LEWIS & CLARK COLLEGE
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