WVSU Housing Cancellation Form

Office of Housing and Residence Life

Housing Cancellation Form / Request to be Released from Housing Contract
Dear Yellow Jacket,

We are sorry to hear about your decision to cancel your housing with us, but we understand and respect your choice.

If you need any assistance in the future, please don’t hesitate to reach out. We’re here to support you and are happy to help in any way we can.

Best regards,

Office of Housing & Residence Life
Completeing this form will also cancel your selected meal plan for the academic year.

If you plan to commute, you have the option to purchase a "commuter" meal plan through our Office of Student Accounts.

Please note: You are responsible for any charges incurred from your check-in date to your check-out date, including used meal plan swipes and flex dollars.
Student Information
Full Name*

First NameMiddle NameLast Name
Student A # *Inaccurate A#'s will delay your application being processed.*
Ex. A0000000
West Virginia State University E-mail address*
example@wvstateu.edu
Residence Hall*

Sullivan HallDawson HallKeith Hall
Room Number: *
Room 101A
Program of Study at WVSU (Major)*
Student Classification*

First Time FreshmanTransfer StudentSecond Semester FreshmanSophomoreJuniorSeniorGraduate Student
Term of Cancellation*

Fall 2024Spring 2025
Specific Date of Cancellation Request*

MonthDayYear
Date
Expected Move-Out Date of your Residence Hall*

MonthDayYear
Date
Meal Plan Decision*

I do not currently have a meal plan.I wish to cancel my meal plan as well.I wish to keep my meal plan.
Reason for Cancellation*

GraduatingTransferringWithdrawingGetting MarriedActive Military DutyMedical Reasons (additional documentation may be required.)Financial ReasonsStudent TeachingOff-campus internshipOther.. please specify below.
If you selected other, please explain:
If you are transferring, please list college/university of transfer below:
Reason for Transfer or Withdrawal from WVSU
Cell Phone Number*

Area CodePhone Number
Gender (Optional)
Are you an International Student?*

YesNo
Are you a WVSU Athlete?*
If you answered yes to the above question, please select which sport(s) you are apart of.*

Not an athleteCross CountryBaseballFootballGolfMen's BasketballMen's TennisSoftballTrack and FieldVolleyballWomen's BasketballWomen's TennisWomen's SoccerAcrobatics & Tumbling
Request to be Released from Housing Contract during Semester

If you will still be enrolled as a student but are requesting to be released from your housing contract, please complete the following section..
Where will you be living after move out?*

Commuting from Parents/Guardians Home.Commuting from Home of Relative other than a Parent/Guardian.Living in Off-Campus Housing/ApartmentOther (please specify)
Please give details on your reasons to request to be released from your housing contract. *
Please be as detailed as possible to better assist our office in reviewing your request.
By signing below, I confirm that I am submitting the required documentation to cancel my current housing assignment for the specified period. I acknowledge that I am responsible for any charges incurred from my check-in date to my check-out date, including meal plan swipes and flex dollars used. I understand that once the cancellation is processed, I will need to reapply and complete all necessary steps to secure a future housing assignment.
Student Signature*

Clear
For additional information regarding this cancellation request, contact the Office of Housing and Residence Life at 304-766-5707 or by email at reslife@wvstateu.edu.
Should be Empty:

Office of Housing and Residence Life

Student Information

Request to be Released from Housing Contract during Semester