Housing Exception Form Return to:

Office of Residential Life 1101 West College Avenue

Jacksonville, IL 62650 217.245.3012 | 217.245.3893 (fax)

reslife@mail.ic.edu

Living on campus is a unique experience where you will be immersed in the liberal arts experience as well as the history of Illinois Colleges hilltop campus. You will be presented with hundreds of opportunities to learn and grow as a person, all the while making friends to last a lifetime. Illinois College believes that living on campus is an important aspect of a private, liberal arts education. Studies have shown that students who live on campus are more involved and are more likely to graduate. However, exceptions to the housing requirement are allowed on occasion to respond to needs that cannot be accommodated in the residential setting. To request an exception to the Illinois College housing policy, please complete the form below.

Illinois College Housing Policy: All students with fewer than 88 credit hours at the beginning of the academic year must live on campus for the entire academic year. Students to whom this applies will be responsible for the full room and board cost, which will automatically be charged to their account. Exemptions for specific reasons must be filed in the Office of Residential Life by November 1 for the following Spring semester and by March 15 for the following Fall semester. A housing exception form must be filled out annually by anyone who does not meet the Illinois College housing policy requirements.

Contact Information: Please complete this form electronically before printing and signing it.

Name: ID#: For Academic Year: Semester:

Email: Phone #: Requested Living Arrangement: _____________________

Home Address: City: State: Zip: For Students Not Intending to Live with Parents:

Anticipated Local Address: City: State: Zip: For Transfer Students Only Please describe your living situation at your most recent institution:

Explanation for Request: (Please attach additional sheets or documentation, if necessary.)

I have read and understand the information regarding the Illinois College housing policy as stated in the Blue Book. By signing this form, the student and parent are agreeing to the following: I certify that all information reported is accurate. If asked, I will provide information that will verify its accuracy. I understand that if I am granted an exception to live with my parents I must maintain that residence for the duration of the academic year. If this changes, I will be held responsible for room and board costs for the terms affected unless a separate exception form is filed and approved.

Student Signature: ______________________________ Date: ______________________

Parent Signature: _______________________________ (Required for requests to live at home with parent) Date: ______________________

OFFICE USE ONLY Date Received: _______________ Decision:

Referred to _________________ on (date) ______________. Approved Type: _____________ Date: ______________ Denied Date: ______________

Comments:

Revised 2/17/14

Name: ID: Email: Phone: Home Address: City: State: Zip: Anticipated Local Address: City_2: State_2: Zip_2: Date: 2/17/14Date 2: 2/17/14Year: Semester: Requested Living Arrangement: Explanation: Other institution living: