Freshman Exemption Form

Student Information:

Last Name:

First Name:

Middle Name:

MyWSU ID:

Current Address:

City:

State:

Country:

zip code:

Current Telephone (permanent):

Cell Phone:

Date of Birth:

mywsu email:

personal email:

Semester Hours:

Current: (hours enrolled in for the semester)

Accumulated: (cumulative college credits completed)

Please indicate the semester for which exemption is being requested:

academic fall and spring semester

spring only

I would like to be exempt from living in Fairmount Towers or Brennan Halls because
(check all that apply):

I will be commuting from home and living with my parent(s) or legal guardian(s) in the Greater Sedgwick County Area.**

I will be living with an aunt, uncle or grandparent in the Greater Sedgwick County Area.***

I am married or will be married prior to my first day of classes at WSU.
(Please note: Wheatshocker Apartments are available for family or married housing.)

I will be taking fewer than 12 credit hours.
Please explain why you are taking less than the required 12 hours in the field below.

I plan to live in official Greek housing.
List which chapter:

I have already lived in Fairmount Towers for two full semesters.
Indicate semesters and years:

I am 21 years of age or older.

I have 30 or more transfer hours.

Other (Please explain your reason for requesting an exemption in the field below)

**Greater Sedgwick County area includes all of Sedgwick County and Andover, Augusta, Belle Plaine, Benton, Douglass, Mulvane, Newton, North Newton, Potwin, Rose Hill, Sedgwick, Towanda and Whitewater.
***Please send or bring to the Wichita State University Housing office documentation for verification. (Documentation includes a letter from the person you will be living with explaining why you are living there and utility or lease agreement.)

Anticipated address while attending WSU

Address:

City:

Zip Code:

Name of Person you will be staying with:

Relationship to you:

I have read this Freshman Exemption Form and understand that I am NOT automatically exempt from WSUs residency requirement. I understand that I will receive an email letting me know whether my request has been approved or denied. I also understand that if I have already signed a contract and am now trying to move out of on-campus housing, this form does NOT release me from any amount due or from the contract cancellation fee clarified in the cancellation section of my Housing and Residence Life contract.

If your request is approved, you are encouraged to contact the housing office to re-apply for future housing (316-978-3693).

Signature of student:
(By typing your name you consent that this electronic signature is valid and will hold you to all terms and conditions in this contract.)

Date:

Parent Signature:
Parents signature required if student is under 18. (By typing your name you consent that this electronic signature is valid and will hold you to all terms and conditions in this contract.)

Date: