Current Students /
Residential and Commuter Life /
Break Housing Request
Required fields are marked with an asterisk.*
College Ave. Residence Hall
Sheridan Ave. (Houses and Apartments)
College Ave. (Houses)
Residence Hall Room Number*
I plan to*:
Stay until the following date:
Please indicate below if you plan to stay for the entire break:
Reason for Request*
If other, please explain.
If you are staying to work, employer verification must be turned in by due date of break application for you to be considered. No exceptions.
I have read and accept the Break Housing Policies & Procedures. The information I have provided on my request is accurate. I have also had an opportunity to ask questions regarding Break Housing, including any questions regarding security risks, reduced staffing, services and facilities. I accept full responsibility and release Capital University from any loss, damage or injury that I may sustain while on campus during break.