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Along with this form, the following additional documentation must be submitted: (1) A copy of your Degree Evaluation 

(accessible on WebPortal) showing that studying abroad/interning is a degree requirement (2) A copy of the acceptance letter 

to the study abroad/internship program 

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If your request is approved, the applicable cancellation fees will be charged. 

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I am an international exchange student leaving SDSU. 

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No further documentation is required. OHA will verify your status with campus officials. 

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If your request is approved, the applicable cancellation fees will be charged. 

I am an SDSU student leaving to study abroad/intern. 

I am graduating. 

w

No further documentation is required. OHA will verify your status with campus officials. 

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If your request is approved, the applicable cancellation fees will be charged. 

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I am in the military and am being deployed. 

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Along with this form, the following additional documentation must be submitted: (1) A copy of your duty orders 

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applicable cancellation fees. 

No further documentation is required. The Office of Housing Administration (OHA) staff will verify your status with 

campus officials. 

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If your request is approved, a 30-day rent fee will be charged (beyond the day you check out of your room) and any 

applicable cancellation fees. 

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I have a medical hardship and will continue attending SDSU. 

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In addition to completing this form, registration with Student Disability Services (SDS) must be completed. OHA will 

confer SDS regarding your medical hardship request. 

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If your request is approved, a 30-day rent fee will be charged (beyond the day you check out of your room) and any 

If your request is approved, the applicable cancellation fees will be charged. 

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I have a financial hardship and will continue attending SDSU. 

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Along with this form, the following additional documentation must be submitted: (1) A copy of your Financial Aid award 

letter (2) Documentation of a significant change in your financial condition since the cancellation deadline (e.g., guarantor 

bankruptcy documents, guarantor unemployment filing, guarantor divorce/separation filing). 

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If your request is approved, a 30-day rent fee will be charged (beyond the day you check out of your room) and any 

applicable cancellation fees. 

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Signature

Date

I plan to check out of my room on: 

Date 

I understand that I am officially requesting to cancel my Student Housing License Agreement. 

Note: Student must make an appointment with the RA/CA in order to 

properly check out. Improper check out may result in additional fees. 

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: 

•

I have read and understand the procedures for contract release. If I decide to cancel this request, I will notify the 

Office of Housing Administration. 

•

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•

I understand that submission of this request does not guarantee that I will be granted a release from the License 

Agreement. If my request is not approved, I will be responsible for all housing and dining charges for the full fee 

period (See Student Housing License Agreement, Terms and Conditions, Section 9.b). 

•

I understand that E-bill charges will not be stopped until I have properly checked out of my room. 

•

If requesting to be released for spring semester, I must check out by end of the fall semester. Failing to do so will 

automatically cancel this request. 

(619)

AN 

D

IEGO 

CA

92182-1802 

(619)

594-5742

T

ELEPHONE

S

594-6202

F

AX

Last Name

First Name

OUSING 

Date Received at OHA:

O

FFICE OF 

H

A

DMINISTRATION 

(OHA) 

S

AN 

D

IEGO 

S

TATE 

U

NIVERSITY

Hall 

Telephone/Cell Number

CONTRACT RELEASE REQUEST 

The Student Housing License Agreement is a legally binding contract in effect for the full academic year. 

Contract Release Requests 

will only be considered in the event of one of the following circumstances. All other requests will be denied. 

Please check the box that is most applicable to you and follow the instructions for any additional steps:

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I am withdrawing from SDSU and will no longer be a student. 

SDSU RedID