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     Room Change Request

Please complete this form to request a Room Change from University Housing

The first room change is free of charge. You will be charged $20.00 for each additional change.
Please be aware that changing your room from double to private will increase your room and
board rate, and by changing your room you agree to pay the extra cost.
(All fields are required)

Name:  
E-mail:  
Important!
Please double-check your e-mail address.
Social Security #:  
Hall:  
Room:  
Extension:  
Which semester do you want this change to take effect?
Fall
Summer
 Spring
Current Room Status
Private Semi-private
Change to
Private Semi-private
1st Choice Hall/Room:  
2nd Choice Hall/Room:  
Roommate Preference:  
Comments

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NSU University Housing · 622 N. Lewis Ave. · Tahlequah, OK 74464
918-456-5511 ext. 4700 · Fax: 918-458-2321