KAUFMAN HALL

EXTENDED OVERNIGHT GUEST PASS REQUEST FORM

ALL FIELDS ARE REQUIRED!

- REQUESTS MAY ONLY BE SUBMITTED A MAXIMUM OF 3 DAYS IN ADVANCE -

HOST (RESIDENT) INFORMATION

Resident Last Name:

Resident First Name:

Resident E-Mail Address:

@ Number:

Hall: SELECT NAGLER ALUMNI COED KAUFMAN Room:

ROOMMATE INFORMATION

Roommate Name: Roommate @ Number:

(Triples and Quads Only) Roommate Name: Roommate @ Number:

(Quads Only) Roommate Name: Roommate @ Number:

Before submitting this form my roommate(s) was/were notified that I will be having an extended guest during the dates listed below and have given me permission.

GUEST INFORMATION

Guest LEGAL Last Name:

Guest LEGAL First Name:

*Guest must provide LEGAL first and last names that match their ID.

Guest Date of Birth:

Guest Gender: SELECT MALE FEMALE

Arriving on: Leaving on: *Maximum of 5 nights.

Please be aware that your request may be denied if you have exceeded the amount allowed in the month or if your guest privileges are suspended. Your guest must be registered by 4PM the day they are scheduled to arrive (Monday through Sunday). If your request is received after 4PM, your guest will not be registered and will not be able to stay overnight. Please be aware that your guest will have to bring a valid form of identification. Resident host must be with guest at all times while in the residence halls.

By submitting this form, I understand that my guest will abide by the residence hall policies outlined in the Resident Handbook, and I will be held responsible for the behavior of my guest.

Submitting this form does not mean your guest is approved. You will receive an e-mail confirmation indicating whether your request was granted or denied.

*There is no Extended Visitation during recess (Summer and Winter) periods.