2025-2026 Student Request to Move-off Campus Form

2025-2026 Student Request to Move-off Campus Form
Student Information

Please enter your student information into each required field below
Name*

First NameLast Name
Student Email*
example@my.trine.edu
Phone Number*
Please enter a valid phone number.
Building*
Select your current campus housing location
Room Number
Ex. 101 A
Enrollment Date*

MonthDayYear
Date in which you became a Trine student
If approved, what meal plan would you like?*

19 Meals/Week10 Meals/Week50 Meals/Semester (Commuter)Decline Meal Plan

Move-off Exemption Options

Trine University Housing Policy requires all students, who are enrolled as fulltime, to live in campus housing. To request an exemption, please see the reasons listed below.
I am requesting to live off-campus beginning Date* for the following reason(s):
*

Deposit and Deposit Refund and Cancellation: To cancel a room assignment, this form must be submitted to the Housing Office by May 1 for the following fall semester. Failure to give written notification by May 1 or breaking the housing contract anytime during the academic year will result in forfeiture of the $150 Housing Deposit. Additionally, students who cancel this room and board contract on or after August 1, 2024, will be required to pay room and board charges for the entire contract term.
Date of Birth*

MonthDayYear

Married or Dependent Child Status

You may use the drop box below to submit your marriage license, dependent I-20, dependent DS-2019, or birth certificate. You may also physically bring these documents to the Housing Department.
Upload your Documents here in PDF format.

Please label each document; (LAST NAME_DOCUMENT TITLE)
Cancelof
I would like to submit a physical copy of at least one of the required documents listed above to the Housing Department.*

YesNo

Parent/ Legal Guardian Waiver and Release of Liability for Off-Campus Residence

Parental/ Legal Guardian signature is required if the student is under the age of 21.
Parent/ Guardian Name*

First NameLast Name
As the parent or legal guardian of, First Name Last Name, I agree to the following statements:

I waive and release Trine University, their directors, officers, trustees, administrators, and employees from all claims for any liability, injury, loss, or damage and assume all risks, known and unknown incurred by the above listed student while not living in university housing. Additionally, I accept personal responsibility for any liability, injury, loss, or damage in any way connected with off-campus living. I acknowledge that my student's reason, as listed above, to move off campus is accurate. Additionally, I understand that false information provided on this form may lead to a student being dismissed from Trine University.
Parent/ Legal Guardian Signature*

Clear
Date*

MonthDayYear

Student Signature and Today's Date
I understand that by not living on campus, I may lose a portion of my financial aid.*

Clear
Today's Date*

MonthDayYear
Should be Empty:

Student Information