Request for Check Out Extension

This form is only for current resident use. Please read the following carefully.

That I am a current resident and student at OSU Institute of Technology and I understand that I am required to follow all the policies and procedures as I would during a in session periods of any semester. NO VISITORS OR ALCOHOLIC BEVERAGES ALLOWED ON CAMPUS DURING THIS TIME. I also understand that if a policy is violated the permission and privilege of having an extension to check out which can result in immediate removal from the Residence Hall areas. Also, I understand that may be subject to the student conduct process for any violations of policy.

Take note that submitting this form is not a guarantee of approval for request.

If you see this don't fill out this input box.

Student Name*

What is your Campus ID (CWID) number?*This the number on the back of your student ID.

Where do you currently live on campus?*Your building and room number.

Phone Number*List a phone that you can be reliably reached at.

University Email*University email is an official means of communication. By providing this, it helps save time.

Requested Check Out Date*Select the date and time you would like to extend your check out to.

Reason*Please explain the reason you should be considered for a check out extension.