Contract Release Appeal Form

Please review this Contract Release Form and the corresponding website in its entirety for detailed release guidelines, policy, and procedures. Release from the Residence Hall/Apartment Contract is subject to review by the Contract Review Committee and Housing & Residence Life. You will be notified of the status of your request within 14 days of the Committee Review which takes place every 1st and 3rd Wednesday of each month while the University is in session. Requests will not be reviewed unless all necessary documentation is attached.

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First Name

Middle Name

Last Name

UNA Student IDPlease use the following format: L00XXXXXX (8 Digits)

UNA Email Address

Phone Number

Current Housing Assignment

Current Room Number/Apartment Number

Term In Which You Are Requesting Release:

If approved, I plan to check out on the following date:

Reason for Release RequestChoose the applicable reason and attach appropriate documentation

If you are withdrawing from UNA and transferring to another institution, please list the institution below.

Please detail your extenuating circumstances for consideration by the committee.

Documentation #1Valid files are: JPG, PNG, PDF, DOC, DOCX, PPT, PPTX, XLS, and XLSX

Documentation #2Valid files are: JPG, PNG, PDF, DOC, DOCX, PPT, PPTX, XLS, and XLSXIf applicable

Documentation #3Valid files are: JPG, PNG, PDF, DOC, DOCX, PPT, PPTX, XLS, and XLSXIf Applicable

By completing and signing this Contract Release Request Form, I am stating that I have read and understood the guidelines and that I wish to be released from my responsibility for my signed contract. I understand that submission of this request does not guarantee that I will be granted a release from the contract. If my request is not approved, I will be responsible for all housing charges under the contract provisions. If I am released from the contract and leave university housing, I understand that I have relinquished my space. Should I later decide to live on campus, I must reapply for on university housing. I certify that the information provided with the Contract Release Request Form is accurate and that the submission of false documentation can be subject to disciplinary action by the University of North Alabama.

I agree to the Terms and Conditions as outlined above.

I agree

Please make sure all required fields have been filled out correctly.

Your Contract Release Request Form has been submitted. You will be contacted within 14 days of the Review Committee decision. Please check your UNA Email for additional details and status updates.

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Contract Release Appeal Form

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