5/1/17
Student Housing Accommodation Request Appeal Form
The purpose of this form is to request a review of the College's determination of an accommodative
housing request. You will be notified of the decision of the appeal within 10 business days past the
submission date. You will be notified of the decision of the Vice President for Student Affairs via e-mail.
Student Name_________________________________________________________________
Student ID Number: 70_________ E-mail _________________________________________
Cell Phone Number ( _____) _________ Date of Birth ______________________________
Current Address _______________________________________________________________
Please provide a description of why the decision should be reviewed.
Please return this completed form to:
Vice President for Student Affairs
Kehoe 616A
518-564-2280
Fax 518-564-3284
student.affairs@plattsburgh.edu