Hello Future Resident,

The Housing Application will exclusively be available online. All the required forms are fillable PDF files. There is only
one (1) form- the Signature Page and Guarantor Agreement that needs to be printed, hand signed and returned to the
Housing Office OR electronically signed in Adobe. If you do not have access to print this form, please let the Housing
Office know. We will be happy to further assist you.

When you receive the Housing Application or access them from our website, you will need to right click-“save as”- and
save the document with your first and last name before the title of the document (i.e.- John Smith 2024-2025 Housing
Interest Form Packet). Then open the PDF on your computer and the forms will be ready to fill out. Do not use the PDF in
Google Forms, as it will not work properly.

Some information will auto-populate from prior pages from within the application form you are working on. If you scroll
over the blue fillable space, a small dialog box will appear letting you know the information that is required for that space.

Before sending the completed application back, you will need to hit “save” again to save your work. Please email the
completed application to housing@redwoods.edu. Please make sure you email the application as a PDF attachment as its
own email.

Please note, in an effort to prevent student debt, if you have an outstanding balance of more than $1,000 with College of the
Redwoods, the housing office will NOT process your application.

If you would like to do the application from your smart phone, you will need to download “Adobe Acrobat Reader: PDF
Viewer, Editor & Creator” from your phone’s app store. Once you download the app, you will
be able to download the forms, fill them out, save, and send it back to housing@redwoods.edu.

If you have any issues with the fillable PDFs, please give us a call at 707-476-4294. We are looking forward to having you
here on campus!

Jason Maki
Interim Director of Housing Operations
Pronouns: he, him, his
Phone: (707)476-4294
Fax: (707)476-4420

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 College of the Redwoods - Department of Residential Life
License Agreement for Use of Housing Facilities - Academic Year 2024-2025

Welcome to the College of the Redwoods Residence Halls. Please read this agreement carefully as it sets out
specific rights and responsibilities of both the College and Student.

CONTENTS
I. PERIODS OF OCCUPANCY
II. REGULAR OCCUPANCY CHARGES AND PAYMENT SCHEDULE
III. DINING LICENSE CHARGES, TERMS, AND CONDITIONS
IV. TERMS AND CONDITIONS OF OCCUPANCY
V. MAINTENANCE OF PREMISES
VI. RESTRICTED ITEMS
VII. GENERAL TERMINATION OF LICENSE BY THE COLLEGE
VIII. TERMINATION OF LICENSE FOR INSUFFICIENT UNITS, INADEQUATE GRADE POINT AVERAGE, OR
WITHDRAWAL FROM THE COLLEGE
IX. TERMINATION OF LICENSE BY THE STUDENT
X. REQUIRED AND OPTIONAL AGREEMENTS

I. PERIODS OF OCCUPANCY
Housing and Dining License Agreements may be entered into for one semester or for two semesters. There are 150 total
spaces available for students in the CR Residence Halls. Of these 150 spaces, 120 residents may be required to have Full-
year contracts. The remaining 30 contracts may be either Fall-only, Spring-only, or Full-year contracts. The Fall-only option
will be granted to the first 30 people who ask to be considered for this alternative. Full-year contracts are more
expensive when issued as two separate single semester contracts, such as Fall-only or Spring-only. Spring-only contracts will
be granted if space is available.

College of the Redwoods (College) hereby grants the student (Student) permission to occupy a Residence Hall space as a
licensee for the following term(s) unless sooner terminated under the provisions of this License Agreement. All residents are
required to subscribe to the college’s meal plan (except during the Summer session). The cost of the meal plan is included in
the housing cost itemized below. The Housing and Food Services License is non-transferable.

SUMMER SESSION: Friday, May 24, 2024 – Friday, July 19, 2024. (Checkout before 12 noon) Cost: $1,182. The
student must be enrolled for a minimum of six academic units for the full summer session to be eligible for housing. All
other terms of this contract will apply. (No meal plan is included or required during this session. A $155.00 refundable
damage deposit is included in fee.)
Cost: Summer 2024
Housing $ 1,027.00
Damage Deposit $ 155.00
Total $ 1,182.00

FULL YEAR: Monday, August 19, 2024 – Saturday, December 21, 2024, and Wednesday, January 15, 2025 –
Saturday, May 17, 2025. Cost: $8,774. Full-year students will occupy their space for the academic year as long as
classes are in session, and they remain eligible according to the standards specified herein. NOTE: Billing for the
Full Year contract will be split into two charges; in Fall 2024, the student will be billed $4,712. In Spring 2024,
the student will be billed the remaining $4,062.

Cost: Full Year 2024-2025

Housing $4,334.00
Fixed Cost, Dining Services $ 120.00
Food Service Credit $4,010.00
• This is the amount put onto the meal card
Damage Deposit $ 310.00
Total $8,774.00

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RETURN TO HOUSING OFFICE

FALL SEMESTER ONLY: Monday, August 19, 2024 – Saturday, December 21, 2024 Cost: $4,712.00. To
qualify to occupy the space after December 21, 2024, the student must be eligible for re-enrollment for the
Spring 2025 Semester, have pre-registered and extended to a full year housing contract no later than November 17,
2024.
Cost: Fall 2023
Housing $2,492.00
Fixed Cost, Dining Services $ 60.00
Food Service Credit $2,005.00
• This is the amount put onto the meal card
Damage Deposit $ 155.00
Total $4,712.00

SPRING SEMESTER ONLY: Wednesday, January 15, 2025 – Saturday, May 17, 2025. Cost: $4,712.00. On a space-
available basis, the Housing Office will begin reviewing Spring Only contracts starting November/December 2024.
Cost: Spring 2024
Housing $2,492.00
Fixed Cost, Dining Services $ 60.00
Food Service Credit $2,005.00
• This is the amount put onto the meal card
Damage Deposit $ 155.00
Total $4,712.00

**All Students will be required to vacate the halls during the following closure: **
 Winter Break: 12:00 p.m. Saturday, December 21, 2024, through 9:00 a.m. Tuesday, January 14, 2025.
Please understand that there will be an additional fee of $20/day for Winter and Summer Break, as it is not
covered in the License Agreement.
**If interested in staying in the residence halls during these breaks please pick up a contract addendum from
the Housing Office. Room codes is subject to be changed during these breaks, and it is necessary to complete
the addendum if you are planning to stay during these closures:**
 Summer Break: 12:00 p.m. Saturday, July 20, 2024, through 9:00 a.m. Sunday, August 18, 2024.

Preference for stayovers will be given to full-year students with the next preference given to incoming Spring Semester
students. Students with Fall Only contracts will not be accepted for Winter Break occupancy. Students must have pre-
registered no later than December 21, 2024. (No meal plan is included or required during these periods and Dining
Services may not be available during the breaks listed above)

The College shall make specific room assignments, observing the student’s stated preference(s) when possible. Students
preferred roommate request is not guaranteed.

II. REGULAR OCCUPANCY CHARGES AND PAYMENT SCHEDULE

The student shall pay the College for room and housing services. The cost includes a $75 nonrefundable Student Activity
Fee ($37.50/semester) which will directly benefit the student in the form of Residence Hall programs and activities. The
Student Activity Fee is included in ‘Housing’ charges outlined above. The contract charges also include a $310.00 ($155 per
semester) damage deposit. If all housing fees have been paid and the premises have been maintained in accordance with
the provisions of this License Agreement, the College will return the damage deposit to the student upon termination of
his/her/their occupancy.

FIRST PAYMENT
Regardless of the term or contract type, the down payment of $500 is due after housing has reviewed your application and it is
deemed complete. You will be notified via email and/or phone call to submit your down payment to secure your occupancy. The
$500 down payment is applied towards your housing charges outlined above. Financial Aid cannot help with the $500 down
payment.

For any contract type, (Full Year, Summer, Fall Only or Spring Only) Housing Students have three options for making
payment. The first option is cash or credit card payment in full before the start of each term. The second option is paying the
difference between the student’s total housing charges and the amount of aid or loans expected. The third option is to make
payments using the College’s third-party payment plan administrator, Nelnet Business Solutions (NBS). Each option is
described below in more detail.

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 PAYMENT OPTION ONE - FULL PAYMENT PRIOR TO START OF TERM
Cash, check, or credit card payment can be made in full prior to the start of the term.

PAYMENT OPTION TWO

If the student expects to pay a portion of their housing costs with financial aid or loan proceeds, payment prior to the
start of the term can be made for the difference between the student’s total housing charges and the amount of aid
or loans expected. Please note that the Financial Aid Office can only provide funding confirmation if the
student has fully completed the Financial Aid application process. If the student chooses the full pay option,
either the full payment or full payment less verified financial aid/loan proceeds must be made prior to the start of the
term.

OPTION THREE – NBS PAYMENT PLAN

Through Nelnet Business Solutions (NBS) a payment plan can be set up so the housing charges can be spread out
over multiple months. You can sign up for NBS through WebAdvisor at www.redwoods.edu. The number of
payments available depends on how early the payment plan is set up. Each payment plan concludes before
registration starts for the following term. The earlier the payment plan is set up, the smaller the payments will be.
NBS uses automatic bank payments (ACH) or automatic charges to your credit or debit card, depending on which
option you choose when you sign up at https://webadvisor.redwoods.edu. Once the student signs up for Nelnet, all
charges posted to the student account will be included in the automatic payment plan, including registration fees and
housing charges. If the student does not want an individual charge to be added to their payment plan, a cash, check,
or credit card payment can be made at the CR Business Office. If payment is not made at the business office, any
new charges on the student account will result in an adjustment to the NBS automatic withdrawal. Conversely, once
an NBS payment plan is set up, any credits or financial aid that are posted to the account will automatically cause an
adjustment downward of the remaining NBS automatic payments.

Questions about payment options can be submitted to the CR Business Office.

PLEASE SELECT ONE OF THE OPTIONS BELOW:

1- Student will submit full cash, check, or credit card payment prior to the start of the term

2- Student will submit full cash, check, or credit card payment, less any pending financial aid, prior to the
start of
the term (Pending aid must be verified by the Financial Aid Office.)

3- Student will sign up for the NBS payment plan. Sign up for the NBS payment plan is completed through
WebAdvisor after charges are posted to the student's account.

Please note that in order to move in to the Residence Halls, the student must have made either a full payment or a full
payment less pending aid, or must have a current NBS payment plan in place.

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 This License Agreement only has housing and meal plan fees. It does not include any tuition or other College fees.
 THERE WILL BE AN ADDITIONAL CHARGE FOR ATHLETES WHO NEED TO OCCUPY THE RESIDENCE HALLS FOR
ADDITIONAL PERIODS DUE TO SPORTS SCHEDULES. PLEASE NOTE THAT MEAL CARDS ARE SUBJECT TO NOT BE
ACTIVATED UNTIL THE BEGINNING OF THE SEMESTER. FULL SERVICE DINING OPTIONS MAY NOT BE AVAILABLE
DURING THIS PERIOD.
 IF YOU WILL BE USING FINANCIAL AID TO MEET ANY PART OF THE OBLIGATIONS OF THIS LICENSE AGREEMENT, THE
COLLEGE OF THE REDWOODS FINANCIAL AID DEPARTMENT MUST BE ABLE TO VERIFY ALL FINANCIAL AID AND
GUARANTEE FUNDS AVAILABLE. WHETHER YOU HAVE FINANCIAL AID COMING OR NOT THE FIRST PAYMENT ($500)
IS REQUIRED.
 PLEASE KEEP YOUR COPY OF THIS AGREEMENT AS A REMINDER OF THIS SCHEDULE.
 FURTHER BILLING NOTICES MAY NOT BE SENT.
 FOR INDIVIDUALS WITH FULL YEAR CONTRACTS, THE ANNAUL COST IS NOT SPLIT EVENLY AMONGST THE FALL
AND SPRING TERMS. $4,712 WILL BE CHARGED IN THE FALL AND $4,062 IN SPRING.
 PAYMENTS NOT MADE WITHIN 5 DAYS OF THE DUE DATE WILL BE CONSIDERED DELINQUENT. A CHARGE OF $10.00
WILL BE ADDED TO THE PAYMENT EACH DAY AFTER THE DELINQUENT DATE.
 IF PAYMENT IS NOT PAID WITHIN 7 DAYS OF DUE DATE, A NOTICE FOR THE STUDENT TO VACATE THE PREMISES
WITHIN 72 HOURS MAY BE ISSUED AND YOUR MEAL CARD MAY BE TURNED OFF IMMEDIATELY.

III. FOOD SERVICE CREDIT, CHARGES, TERMS & CONDITIONS

Included in the contract amounts specified above is a flat fee of $60.00 per semester that covers the fixed costs of providing
the dining services for residents on the Eureka campus, plus an individual meal purchase credit of $2,005.00 per semester
per resident which may be redeemed at the C.R. Housing Office in the Mendocino Hall Building room MH 100 at any time
during office hours. This meal plan is not optional; it is required of every student living in the residence halls, and
payments for the plan must be made in keeping with the deadlines specified above.

Dining Hours will be posted on the website and at the Café entrance. If adjustments need to be made to regular hours, notice
will be posted in the Café at least one week before the change. There will be limited hours on most holidays including fall,
winter and spring break. The Café will be closed for the following days: November 23rd-24th, December 21st-January 12th.
Summer hours will be limited to Monday-Thursday 11a.m.-2p.m. and closed during summer holidays. Meal Plans are not
intended to cover all meals throughout the students stay. Students are encouraged to budget accordingly.

Food Service Terms and Conditions

1. Each Student living in the Residence Halls must participate in the mandatory meal plan. Their participation may not
be transferred or assigned to anyone else.
2. Payments may be made in full or in accordance with the NBS Payment Plan as part of the overall License
Agreement.
3. All payments for the housing and meal plan must be made to College of the Redwoods.
4. Students receiving financial aid must make payment in full according to payment schedule. Students expecting
financial aid must present documentation confirming their awards with their application. This documentation, once
reviewed and approved, will defer payment until the financial aid is credited to the student’s account.
5. Payments not made by the due date will be considered delinquent and may result in the meal plan being
immediately deactivated. Failure to make payment will subject the student to a three days’ notice to
vacate the residence halls.
6. No reduction of the meal plan fees is permissible because of dietary or related restrictions, including (but not limited
to) food allergies, vegan, or vegetarian requirements.
7. Meal Card – The meal card can be picked up at the Housing Office during normal business hours. Value is
electronically deducted from accounts as items are purchased.
8. There is no refund for meal plan value purchased. There will be no refund for any value during the license period
or for any value remaining at the end of the dining license agreement period. You must use or lose the required
value purchased during the contract period.
9. Additional meal plan value/credit may be purchased at the cashier window in the Business Office, using cash,
check, or credit
card(credit cards accepted are MasterCard, Visa, Discover, and American Express).

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 10. Full-year and Fall-only residents will have Fall Semester value added to the meal card effective by August 19,
2024.
11. Full-year and Spring-only residents will have Spring Semester value added to the meal card effective January
15, 2025.
12. If at any time the Residence Hall contract is broken by the student or terminated by the College for any
reason, all remaining meal plan funds will be forfeited, and the meal card turned off. If the Student has paid
the full amount on his/her/their contract, the meal card money will remain on the card for the contract period
even though the student may not be living in the Residence Halls.
13. Requests for exceptions to the policy regarding termination of the meal plan must be made in writing to the
Director of Residential Life, College of the Redwoods. Permission to grant the exception is at the discretion of
the Director of Residential Life, or their designee. Exceptions will only be granted due to extraordinary
circumstances.

If you have any questions regarding the Dining License Agreement, feel free to contact the College of the Redwoods Housing
Office at (707) 476-4294.

IV. TERMS AND CONDITIONS OF RESIDENCE HALL OCCUPANCY

The Housing and Food Services License Agreement may not be transferred or assigned to anyone else. A
reservation for space in the Residence Halls is made only when the applicant has returned the completed Housing and Food
Services License Agreement, application form, $500 down payment for room, and other materials as may be required.
Applicants who return their Housing and Food Services License Agreement, required forms, and after all space in the
Residence Halls has been assigned will have their names added to a waiting list. Upon reservation, space is deemed to be
licensed for the entire period of the license. Rooms are licensed double occupancy only unless approved by the director of
residence life.

*Failure to occupy an assigned space before the first day of instruction may, at the option of the College, result in
cancellation of reservation without notice.

*The College reserves the right to change rates and conditions of occupancy upon reasonable notice and to add
such other requirements and stipulations as may become necessary for the betterment of the Residence Life
Program and the general welfare of the students.

A. Behavioral Requirements
Individuals who, in the opinion of the College’s Vice President for Student Services, or designee, pose a danger to
themselves or to other residents will not be permitted to remain in the Residence Halls. All rules and behavioral standards of
the Residence Halls and College are in effect when the Licensee takes occupancy. The student agrees to comply with
such rules and policies as outlined in the Residence Hall "Community Guidelines," the Student Code of Conduct
and Discipline, and with any other rules and regulations as may be adopted by Residence Hall management, the
Board of Trustees, the Redwoods District, the administration, or federal, state, or local laws (incorporated by
reference as though fully set forth). A copy of the "Community Guidelines" will be found in your welcome folder and is
available at https://www.redwoods.edu/housing-. Signing and returning the Required Agreements form indicates you
(the student) have read and agree to abide by the Community Guidelines and all terms set forth in this contract;
these documents are available in the Housing Office and on the College of the Redwoods webpage. If you would
like a physical copy of the “Community Guidelines” or the Student Code of Conduct and Discipline, please contact
the Housing Office.

The College is an alcohol and drug free environment. No student shall possess, consume, have consumed, or be
under the influence of alcoholic beverages or illegal narcotics, including cannabis, at any time on campus or in the
Residence Halls. No Student shall possess at any time any empty alcoholic beverage container on campus or in the
Residence Halls. Residence Hall students violating State or Federal law by possession and/or use of illegal drugs
or alcohol face disciplinary sanctions, up to and including revocation of this Housing License. Revocation of the
Housing License for violation of policies or the Student Code of Conduct does not release the student from his/her/
their financial obligations as outlined in this agreement. Please be advised that the College is extremely serious
about these provisions and will enforce them consistently.

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The College of the Redwoods is non-smoking campus. Smoking is not allowed in students' rooms, hallways, lounges, offices,
or parking areas. Students living in the halls are subject to all provisions of Board Policy 3570 “Smoking” and Administrative
Regulation 3570, “Smoking on Campus”. Smoking is not allowed anywhere on campus.

B. Academic Expectations
The Residence Halls are an academic learning environment. Students that are admitted into the Residence Halls must
maintain an academic workload of at least 12 academic units (unless a DSPS accommodation request is submitted to the
Housing Office) and a minimum GPA of 2.0 each semester while living in the Halls.
C. Lost or Stolen Property
The College assumes no responsibility for any property of the student or by any of the student’s guests or invitees, which is
lost, stolen, damaged, or destroyed in the Residence Halls or the Residence Halls’ parking lots at any time, including periods
when the student is not in occupancy. It is recommended that students carry their own personal property insurance.

D. Room Privacy and Right of Inspection Policy

The College will respect the student’s right to be free from unreasonable searches and intrusions into the student’s living
quarters. The College reserves the right to enter upon the premises for purposes of management, health, safety,
maintenance, and enforcement of applicable rules and regulations.

E. Room Changes
The College reserves the right to change or cancel room assignments up to a 24-hour notice in the interest of health,
discipline, or the general welfare of the students, or to make reassignments for more efficient operation or maintenance.
Students will receive confirmation of the space to which they are being reassigned.

F. Personal Injury
The College shall not be liable for any personal injury sustained by the student or any of the student’s guests or invitees in or
about the student’s room or other areas in or about the Residence Halls.

V. MAINTENANCE OF PREMISES

The student agrees to give reasonable care to his/her/their room and his/her/their bathroom and its furnishings and to
make payment for any damage or loss promptly upon demand by the College.

The student agrees to be jointly responsible with other residents for the protection of the common areas of the Residence
Halls to which the student has access, including its furnishings and equipment.

The student shall vacate the premises in good order and repair, normal wear and tear excepted. In the event the student
fails to maintain the premises in good order and repair, the College shall be entitled to reimbursement. The student’s
damage deposit, or a portion thereof, may be expended for the purpose of payment of either common area or student
room/furniture damage or replacement costs. Additional charges shall be assessed to the student for costs incurred if such
costs exceed the damage deposit ($310 for a full year contract and $155 for a semester contract).

VI. RESTRICTED ITEMS

The student shall not bring to or keep on Residence Hall premises any item restricted by the Student Code of Conduct and
Discipline. In addition, the student may not keep: a) any animal (except a service animal/emotional support animal, must be
documented with College of the Redwoods Housing and DSPS Office); b) any highly flammable materials, firearms,
ammunition, fireworks, or explosives; c) any weapons; d) any waterbed; e) any hotplate, grill, toaster or toaster oven, f)
hoover boards or g) any full-size sofa/lounge chair. Students are permitted to have two small refrigerators and one
microwave in each room. Please wait to purchase these new items until speaking with your roommate upon arrival.

VII. GENERAL TERMINATION OF LICENSE BY THE COLLEGE

The College may revoke this License for any reason by giving up to a 72 hour written notice to the student. The Housing
License revocation process is separate and distinct from the College's Student Disciplinary Policy; however, suspension or
expulsion will have the effect of revocation of this License. Notice shall be served personally upon the student or, at the
discretion of the College, shall be posted in some suitable place upon the housing facility of the student. Termination of this
License or the student's abandonment of the premises shall not release the student from paying any obligation due
to the College or the fee for the entire license period. Upon revocation of the License by the College

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as a disciplinary action or breach of the terms and conditions of the License, including violation of federal, state, or county
probation or nonpayment of fees, the student shall owe the total amount due for the full fee period of the License, plus any
authorized charges.

VIII. TERMINATION OF LICENSE FOR INSUFFICIENT UNITS, INADEQUATE GRADE POINT AVERAGE,
OR WITHDRAWAL FROM THE COLLEGE
As a condition of living in the Residence Halls, the Student must be enrolled and maintain reasonable academic progress.
Failure to meet any of these conditions will subject the student up to three days' notice to vacate. Except in the case of full
withdrawal (in which case continued occupancy of the Residence Halls is not permissible) a student may request an
exception to this clause by submitting an appeal to the Director of Residence Life. Permission to remain is at the discretion
of the Director in consultation with the Vice President for Student Services, and may carry with it additional stipulations or
requirements such as community service, regular meetings with an academic advisor, group workshops, confirmed daily
attendance with instructors, etc. Students who must vacate their room before the end of the License term for academic
reasons are obligated to pay for the full term of the contract. Departure from the Residence Hall must be formalized by
checking out with the Director of Residence Life (or designee).

IX. TERMINATION OF LICENSE BY THE STUDENT

A. Cancellation of Reservation Before Occupancy Begins
Request for termination of the License shall be determined as follows:
1. Notice at least 30 days prior to the beginning of License term
The student may cancel his/her/their reservation for any reason 30 days or more prior to the beginning of the
License term and incur no financial obligation.
2. Notice within 15-29 days of the beginning of the License term
The student may cancel his/her/their reservation for any reason within 15-29 days prior to the beginning of the
License term and incur no financial obligation for doing so, if the College has a person on the waiting list waiting to
contract for the space the student is releasing. Should there be no students on the waiting list; a license
cancellation fee of $300.00 will be charged.
3. Notice within 14 days of the beginning of the License term
The student will forfeit the entire initial down payment amount of $500. There will be no refund made, and the
student will have no further financial obligation to the College.
4. Notice once the Residence Halls have opened
If the Student breaches this License and abandons the premises before the end of the License term or if his/her/
their right to possession is terminated by the College because of the Licensee's breach of this License, this License
terminates. On such termination, the student will forfeit their entire payment and down payment amount. In addition,
they will be responsible to pay the remainder of their housing contract.

B. Termination After Occupancy Occurs

Students will be released from the License obligation only when: (1) the student withdraws from college; and (2) the
Director makes an exception to the full-term License policy based on the welfare of the community, extraordinary
circumstances, or a documented Student emergency. Even if these conditions are met, and the student is released
from the full-term License obligation, the student will be subject to a contract cancellation fee as specified below.
Student Requests to Vacate
Any request for early termination of the License by the student must be made in writing to the Director of Residence
Life at least 15 days prior to the date the student wishes to vacate. This request will be reviewed by the Director and
appropriate Residence Life staff and the request will be approved or denied within 10 days of submission. All
terminations of this License approved within the License term are subject to the application of a pro rata fee equivalent
to the daily room rate. There will also be a contract cancellation fee applied as follows:
(1) Students who are released from the License agreement before the term of the contract has ended will pay a
cancellation fee of $600 if there is no one on the waiting list who meets the criteria to take the canceling Student’s
place in the Halls.
(2) Students who are released from the License agreement before the term of the contract has ended will pay a
cancellation fee of $300 if there is a person on the waiting list who meets the criteria to take the canceling student’s
place in the Halls.
(3) Cancellation requests not approved by the Director of Residence Life could be subject to forfeiture of the entirety of
the term cost. All Requests to Vacate received after Fall semester closing on Saturday, December 21, 2024 will be
subject to this fee.

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 If the early License termination is approved, the student must vacate the premises on the date indicated in the
original request. Departure from the Residence Hall must be formalized by checking out with the Director of
Residence Life (or designee). If the Student does not formally check out with the Director on the date specified,
he/she/they will be charged $20.00 per day until the formal check-out occurs.

Requests for Exemptions/Appeals.

If 1) Student wishes to terminate this License Agreement upon financial terms different than those described above,
or 2) this License Agreement is terminated by CR Office of Residential Life and the student desires financial terms
different than those described above, the Student must submit a “Request to Vacate” form at least 30 days prior to
the proposed date of voluntary termination, or not more than 5 business days after the check- out date in the case
of involuntary termination. CR Office of Residential Life will determine the student’s financial responsibilities
(including the amount of the appropriate refund, if any) in its sole discretion after giving consideration to factors
including but not limited to: a) documented individual circumstances beyond the student’s control which were not
reasonably foreseeable at the time this License Agreement was entered into and by the administration of the
Residence Halls program, b) extent of space available in the Residence Halls and, c) the Office of Residential Life’s
ability to fill the student’s contract with another student.

Return of the signed copy of this License, together with the necessary payment, shall constitute acceptance of this
agreement by the student. (Students under 18 years of age must have this License and the Contract Addendum: Minor
Students in the Residence Halls form signed by a parent, guardian, or person legally responsible.) Acceptance by the
College is subject to review of the application. Students that are accepted into the Residence Halls will receive an
Acceptance Letter via email.

Please go on to the next page to sign the required and optional Agreements.

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 REQUIRED AGREEMENTS 2024-2025

Return of the completed copy of this License Agreement, together with the necessary payment, shall constitute
acceptance of this agreement by the student. (Students under 18 years of age must have this License signed by a
parent, guardian, or person legally responsible.) Acceptance by the College is subject to review of the
application.
HOUSING AND FOOD SERVICES LICENSE AGREEMENT
Please initial the box for the term for which you would like a housing and food service plan. If you are coming for
the 2024 Summer Session (or partial Summer Session for Summer Bridge), you can initial Summer Session as
well as either Full Year, Fall Only or Spring Only.

Summer Session (no meal plan), May 24, 2024 – July 19, 2024

✔ Full Year, August 19, 2024 – December 21, 2024 and January 15, 2025 – May 17, 2025

Fall Only, August 19, 2024 – December 21, 2024 (Only 30 Fall Only contracts are available)

Spring Only, January 15, 2025 – May 17, 2025

1. I (we) have read and understand the entire Housing and Food Services License Agreement and I (we) agree to its
terms.

2. I agree to follow the “Community Guidelines and The Student Code of Conduct and Discipline” as referred to in
the License Packet (Section IV) and agree to comply with the Residence Hall policies and campus
regulations. By completing the form below, you are signifying that you have read, understand, and agree to
follow all the Community Guidelines as set forth in the enclosed document. You also understand that you will be
held responsible for any violations of these guidelines. Further, you understand that should you be removed from
the Residence Halls for any reason, you will still be held financially responsible for the full amount of your
contract as stated in the License Agreement.

Abytha Rose
Student's Legal Name Abytha Newell
Newell College of the Redwoods Student ID # 0372342

444 Beaver Dr Alturas CA 96101

Permanent Address __________________________________________________________________

Street Apt. # City State Zip

Mailing Address ___________________________________________________

(If different from permanent address) Street Apt. # City State Zip

5307080080 1717
Phone # (530)708-0080 Date of Birth 8/23/06
08/23/2006 Age
4/10/2024
Date

Name of Parent, Guardian, or Person Legally Responsible

Christine Nelson
(If Student is under 18 years of age)

Please See Reverse Side Of This Page For

Residential Life Release of Information

10
 Release Of Information

Full Legal Name Abytha Newell CR ID# 0372342

This form will provide the selected department(s) authorization to release your information to the individual(s) listed
below. The Family Education Rights and Privacy Act (FERPA) (20 U.S.C 1232g; 34 CFR Part 99) prohibits College of the
Redwoods from disclosing a student’s information to third parties (i.e. parent, spouse, etc.) without the student’s
written consent
Admissions & Records; Authorizes consent from the student to the Admissions and Records Office and to
the Counseling and Advising Office to release information pertaining to the student’s academic record
to authorized individuals. This information may include dates of attendance and registration, courses
✔ added, dropped and/or withdrawn from, Grade Point Average (GPA), academic standing, billing such as
payments received and debts owed, enrollment status, documents/forms received and their status or
determination, declared program, progress toward program completion, application dates, registration
eligibility and other academic institutions attended.

Financial Aid; Authorizes consent from the student to the Financial Aid Office to release information
pertaining to the student’s academic record to authorized individuals. This information may include
✔ potential financial aid awards, disbursement amounts and dates, refund preference, billing such as
payments received and debts owed, enrollment status, outstanding required documents/forms,
documents/forms received, and other eligibility requirements such as Satisfactory Academic Progress
(SAP) standards.

Housing; Authorizes consent from the student to the Housing Office to release information pertaining to
✔ the student’s on campus housing and charges pertaining to the housing related services to authorized
individuals. This includes billing, payments, housing application status, and housing packet information.

Business Office; Authorizes consent from the student to the Business Office to release information
✔ pertaining to the student’s account receivable record to the individuals listed before. This includes
student accounts balances, payments received, direct deposit information, and prior debts.

INDIVIDUALS AUTHORIZED TO RECEIVE INFORMATION ABOUT YOUR ACADEMIC RECORD

First Name Last Name Relationship Notes:

Christine Nelson Mother

Sign: Date: 4/10/24

11
 Financial Aid Office
www.redwoods.edu/financialaid

We've put together a list of estimated expenses for students who attend College of the Redwoods and live on
campus. Just keep in mind that these costs may vary depending on the choices you make as a student, like how
many courses you take.

We know that finances can be tough, so we want to remind you that financial aid can help cover some
expenses, but it might not cover everything. When your financial aid is disbursed, the money will first go
towards any money you owe to the college, like tuition or housing fees. This means you may need to pay for
books and supplies with your own money if you still have a debt on your student account.

If you have any questions about the estimated expenses, please don't hesitate to reach out to the CR Financial
Aid Office at finaid@redwoods.edu or (707) 476-4182.

California Resident Students

Fees (based on 15 units in both Fall & Spring) $1,470
Books & Supplies $938
Housing $4,644
Food (meal card cost + estimated additional food expenses) $6,715
Transportation $1,764
Miscellaneous/personal $3,609
Total $19,140

Non-Resident Students
Fees (based on 15 units in both Fall & Spring) $10,950
Books & Supplies $938
Housing $4,644
Food (meal card cost + estimated additional food expenses) $6,715
Transportation $1,764
Miscellaneous/personal $3,609
Total $28,620

Oregon Exchange Students

Fees (based on 15 units in both Fall & Spring) $3,960
Books & Supplies $938
Housing $4,644
Food (meal card cost + estimated additional food expenses) $6,715
Transportation $1,764
Miscellaneous/personal $3,609
Total $21,630

I have read and Understand the Cost of Attendance: _______

AN ___________
4/10/24
Initial Date
 Housing Interest Packet

College of the Redwoods – Student Housing Information Form

The following forms are required of all residents. The information is used by the staff in emergency situations and for the assignment of
roommates. All information will be held in strict confidence. If you would like us to be able to share your contact information with your
roommate prior to move in, please check YES on the last page of the Roommate Questionnaire.
1. Student’s Name: Last First MI 2. CR ID # (Required)
Newell Abytha R 0372342
3. Student’s Mailing Address City State Zip Code Country
444 Beaver Dr Alturas CA 96101 United States
4. Preferred Name (Nickname) Phone Number (Area Code and 5. Date of Birth Age 6. Gender
Number)
Abby 5307080080 8/23/06
/ / 17 Female
7. Student’s E-Mail Address: 8. What is your cumulative High School or College Grade Point Average (GPA)?
(Required) 3.4
Newellabby13@gmail.com Did you receive a GED or Proficiency Certificate? No
9. College Level: (Check all that apply)
□ 1st Year College Freshman □ Returning College Student □ Transfer Student □ Athlete □ International Student

10. Food allergies/ dietary restrictions?

No

11. Program of Study? Nursing

12. Type of Occupancy Requested: (Check all that apply, needs to match the selected term on the License Agreement)
□ Summer Session: May 24, 2024 - July 19, 2024 (Must have a Full-Year or Fall-Only contract)
□ Full-Year: August 19, 2024 - December 21, 2024 and January 15, 2025 - May 17, 2025
□ Fall Only: August 19, 2024 - December 21, 2024
□ Spring Only: January 15, 2025 - May 17, 2025
Police Academy- Fall Only: June 9, 2024 - December 14, 2024
Police Academy- Spring Only: January 5, 2025 - July 12, 2025
13. If you are a person with a disability, do you require any special accommodations for housing placement? No
If yes, please explain: (Attach an additional sheet if needed, please list any special accommodations which you require.)
No

14. Have you ever been convicted of a felony? No (*Note: this will not necessarily deny your housing eligibility).
Of what specific offense were you convicted and when?

15. Have you applied for 2024-2025 Financial Aid? Yes

If yes, when did you file your FAFSA?
Have you received your Financial Aid Award Letter from College of the No
Redwoods?
16. Have you lived in the College of the Redwoods Residence Halls before?
If yes, what semester/s?

By signing and submitting this Housing interest form, the undersigned (and if applicable, his/her/their parent or guardian) agrees to be
bound by the terms and conditions set forth in the College of the Redwoods Residence Hall License Agreement (a copy of which is
attached to this application). Providing false information may lead to immediate rejection or removal of applicant from student
housing.
Students Full Name (First and Last): Date:
4/10/24

Parent/ legal guardian's name:

(If student is under 18, signature of parent/legal guardian is required on the "Hand Signature Page" of the Housing Application packet.)

Continue to the next page

13
 Housing Interest Packet
EMERGENCY OR ILLNESS PROCEDURES

IN CASE OF EMERGENCY, ILLNESS, OR INJURY, I CONSENT TO AND UNDERSTAND THAT THE COLLEGE MAY CALL
PARAMEDICS AND - IF NECESSARY - TRANSPORT THE STUDENT TO A LOCAL HOSPITAL BY AMBULANCE FOR
TREATMENT AND CARE.

Student Initials Student Name (first and last):

Emergency Contact Information:

Parent/ Guardian (name) Day Phone:

Night Phone:
Address:
Day Phone:
Parent/Guardian (name)

Address: Night Phone:

Other Contact Day Phone:

Relationship: Night Phone

Family Physician Day Phone:

Check all that apply and explain all checked items:

Drug/Medication sensitivity or reaction

Asthma Heart Disorder _ Allergies

_ Other health or medical conditions of which the College should be aware:

Name of Insurance Carrier Group #

(Please send a copy of the Insurance Card.)

Student’s Name Abytha Newell Date 4/10/24

-----------------------------------------------------------------------------------------------------------------------------------------

If the student is under 18 years of age as of the date the student signs the application, then this form MUST BE
SIGNED ("Hand Signature Page") by a parent or guardian.

I hereby give my consent for emergency medical or surgical care to be given to my son or daughter should the need
arise.

Parent’s Name Date

14
Continue to the next page
 Housing Interest Packet

ROOMMATE PREFERENCE QUESTIONNAIRE

Name
Newell Abytha R
Last First MI

Age: 17 Gender Male Female

PREFERRED ROOMMATE (name)

Your answers to the following questions provide us the information to pair you with a roommate for the coming year.
Please read and answer each question carefully. All your responses are CONFIDENTIAL (we will share your information
with your paired roommate only if you select YES on page 5 of this form) and will be used only to make compatible
roommate assignments. Some questions may require imagination. When selecting your answers, please remember to answer
with the understanding that college life may provide you new freedoms, choices, and opportunities.

Personal Preferences/Personality Descriptions

1) Although there is no smoking on campus (including the Residence Halls):

Do you smoke? No
Would you object to a roommate who smokes? Yes
2) Would you consider yourself to be:

[Please
No Select One]
Preference

3) At what level do you prefer to listen to your music?

Medium
4) Would you be willing to room with a student who has an Emotional Support Animal/Service Animal?
No
5) I prefer to sleep and study in a room that is:

Cool
6) If visiting, you would probably find my room:

Occasionally Clean
7) Do you consider yourself:

Very Social
8) As it relates to sharing my personal belongings with my roommate:

It is not a problem, as long as they ask first.

9) If my roommate were doing something that bothered me, I would:

Not hesistate to ask them to stop.

10) List three hobbies or activities that you enjoy:

Going for runs/ being active Going to get food Hanging out with friends

Continue to the next page

15
Housing Interest Packet

There is a possibility that some of the questions are more significant to you than others. Please indicate the three most
important questions in order so that we can make the best match possible.

1st Priority Question # [Choose]

2nd Priority Question # [Choose]
3rd Priority Question # [Choose]
11) What qualities/habits would your IDEAL roommate have?

12) What academic courses / areas interest you the most?

13) What careers most interests you right now?

14) What campus activities do you plan to participate in?

15) What interscholastic sports do you plan to participate in if any? (Available interscholastic sports: Baseball,
Men’sand Women’s Basketball, Cross Country, Men’s and Women’s Soccer, Softball, Track, Volleyball,
Women's Tennis, Football.)

16) Why did you choose college of the Redwoods, and why do you want to live on campus?

17) How did you hear about College of the Redwoods Housing? (friends, coaches, social media, counselor, etc.)

18) Have you indicated on your Financial Aid Paperwork (FASFA Question 52, see example below) that you are a
foster youth? Example from FASFA - (Question 52. At any time since you turned age 13, were both your parents deceased,
were you in foster care or were you a dependent or ward of the court?) (Please select one)

16
Continue to the next page
 Housing Interest Packet

OPTIONAL AGREEMENT
Would you like for the Housing Office to share your contact information with your assigned roommate? (Please
select one)

*Please note that roommate assignments may change up to Opening Day. * If you or your assigned roommate does not
select“Yes” in this box, the Housing Office will be unable to share their information with you.

Student Name: Abytha Newell Date: 4/10/24

17
 Letter Packet

Summer 2024/ Fall 2024/ Spring 2025

Dear Resident,

This letter is to remind you that College of the Redwoods is a drug and alcohol-free institution, as well
as a smoke free institution. Electronic smoking devices are treated the same as traditional cigarettes. We
want to remind you that these policies are taken seriously, and our community has a zero-tolerance
policy on drugs, alcohol, and smoking. Should any of these policies be violated you may receive a
major violation at the Residence Halls which would lead to initiation of your removal from the dorms.
Each incident will also be forwarded to the Vice President of Student Services and Learning Support or
his/her/their designee for disciplinary action.

Our hope is that this reminder heads off any incidents that might occur and create hardship for any
individual. Please sign and date and return this letter to the Housing Office letting us know you have
received this notice.

We thank you for your cooperation and continue to wish you success in all your goals.

Sincerely,

Jason Maki.
Interim Director of Housing Operations

Print Name Abytha Newell

Date
4/10/24
I have read and understand the information on this page (initial):
Updated 3/5/24

Continue to next page

18
Letter Packet

2024-2025 Academic Year

Dear Prospective Resident,

We have been notified that construction on campus will continue in the 2024-2025 academic
year. The construction noise may possibly be disrupting throughout the day. There may also
be disruptions in power and water as the construction is occurring.

We understand that some individuals may feel that these inconveniences are too great and may
not want to reside in the Residence Halls during the academic year with this information. If
you would like to live in the Residence Halls in the Academic Year, please initial below.

Initial Below

I would like a contract with the College of the Redwoods Residence Halls for the
2024-2025 Academic Year. I understand that there will be construction near the Residence
Halls and accept any inconveniences that may accompany this construction.

Print Name Abytha Newell

Date 4/10/24

19
Letter Packet

COLLEGE OF THE REDWOODS

RESIDENCE HALLS ACADEMIC SUCCESS REQUIREMENT
2024-2025

Dear Prospective Resident:

We are glad that you have chosen to live and pursue your studies while living in the College of
the Redwoods Residence Halls. The Residence Halls are a living and learning environment; and
as such, it is our hope that you will increase in your academic ability, learn more about yourself,
grow in your experiences with others and have a better understanding of your local and global
community. To that end, residents must meet the following requirements:
1. Provide proof of your College of the Redwoods (CR) student identification number. This
number verifies that you intend to be a CR student.
2. Provide proof of enrollment in 12 academic units or more (Full-time student) This will need
to happen each semester before move in. Please submit a copy of your schedule with your
application materials. (DSPS may provide accommodation for total units required)
3. A Student Education Plan (SEP) is required for every Residence Halls student. Please contact
the Counseling Office at (707) 476-4150 to set up an appointment. To be accepted in the
Residence Halls, you will need an appointment set no later than September 9, 2024
(February 3, 2025, for Spring Only contracts). When you call, please identify yourself as an
athlete if you are participating in an intercollegiate sport at College of the Redwoods. When
meeting with counselor, each resident should request an email to be sent to:
Housing@Redwoods.edufor confirmation.
If you have already set up a meeting to complete your SEP, please indicate the counselor’s
name, and date of the appointment: Counselor's name:
Date for SEP Meeting:

Residents who are not enrolled in at least 12 academic units will be issued a removal
letter from the Housing Office and removed from the Residence Halls. *Some
exceptions to this policy may be allowed on a case-by-case basis. Please contact
Housing Office to request an exception to this policy.
Please sign and return with your class schedule. Your signature indicates your
acceptance and understanding of this requirement.

Student Print Name Abytha Newell

Date 4/10/24

I have read and understand the information on this page (initial):

20
Letter Packet

Step: Forward

What you need to know

Priority registration allows you to register early so you can get into courses before they fill up.
To be eligible, you must participate in orientation, complete the assessment process for math and
English course placement, and develop an Education Plan with your counselor or advisor. This
process will help you to clearly define your goals, stay on track, and take the most direct route
from start to finish.

Orientation: Connect with your campus

Orientation allows you to learn about financial aid, registration, tutoring services, important
locations on campus, types of degrees, and more, helping you adjust to your new college.

Assessment: Discover your academic skills

College assessment tests measure your academic knowledge and skills and take the guesswork out of
choosing courses at the right level. You might find out that you are ready for higher-level courses in some
areas or need more preparation in other areas. Your assessment results help you know where to begin in
your college career.

Education Plan: Make the most of your college experience

Your Education Plan, created with the help of a counselor or advisor, is a step-by-step guide
based on requirements to meet your goals and how soon you would like to complete them.
Planning will ensure you take your courses in the right sequence to enroll in the courses you
need when you need them.

For more information, please visit http://stepforward.cccco.edu/ or contact College of

the Redwoods Counseling and Advising Center at (707) 476-4150.

21
 Signature Pages

Please print and sign this page or electronically sign using Adobe acknowledging that all information is
accurate. You will need to return this page as well as the signed Guarantor Agreement. Once the housing
application is verified complete by the Housing Office, you will be notified by the Housing Office to submit the
$500 down payment to secure your housing occupancy (pending Financial Aid file completion, if applicable).
Housing accepts these forms of payment: personal check, cashier’s check, credit card (MasterCard, Visa,
Discover, or American Express). Make sure to carefully read all the information and answer all the questions in
your application. By returning these two hand signed pages, as well as submitting all other application material,
you will be entering into a legally binding agreement and therefore it is crucial for you to understand every
aspect of the agreement.
I have read, understand, and completed the following application forms:
• License Agreement (page 4- payment option, page 10- License Agreement, page 11- Release of Information)
• Sign Page- Signature page (page 22) & Guarantor Agreement (page 23) (Needs to be returned with a copy
of Guarantor’s ID)
• Payment Plan Worksheet (page 12)
• Housing interest form packet (page 13- Housing Interest Form, page 14- Emergency Illness Form, pages 15-17-
Roommate Preference Questionnaire)
• Letter packet (page 18- Zero Tolerance Letter, page 19- Construction Letter page 20-Academic Success
Requirement)
• Minor Addendum (page 25) (for residents under the age of 18)

I have read and understand the following informational application forms:

• Community Guidelines
• Student Code of Conduct (AP 5500)

Student Name: Abytha Newell

Student Signature: .

Date: 4/10/24

If student is under the age of 18 while completing the Housing Application:

Parent/ Guardian Name: Christine Nelson

Parent/ Guardian Signature: .

Date: 4/10/24

22
 Signature Pages

Summer Session ✔ Full Year(Fall 2024 & Spring 2025) Fall Only Spring Only

Guarantor Agreement 2024-2025

ALL residents are required to have a guarantor, even if the resident is over the age of 18. This form will
need to be signed and returned with a copy of the Guarantor’s ID or driver’s license.

In the event of any breach of any terms of the Student Housing License Agreement or the Student
Housing Handbook by Resident, the Guarantor shall be jointly and severally liable for any damages,
financial or physical caused by Resident, including any legal fees incurred in enforcing the Residence Hall
License Agreement, the Student Housing Handbook, or the conditions outlined in the Residence Hall
Payment Plan Worksheet. The Guarantor shall have no longer than fifteen (15) days to make full
payment of such amounts that are due.
College of the Redwoods is not obligated to inform or discuss with the Guarantor any situation
regarding the Resident.

I (Guarantor) understand that should the student default on payments, I promise to pay all the unpaid
debts as indicated on the Residence Hall License Agreement in full, including late fees collection and
legal fees.

I (Guarantor) understand that I may be eligible for parent loans (PLUS) available through the
Department of Education. Additional information can be found @ www.studentloans.gov

I (we) have read the entire License Agreement for Use of Housing Facilities and License Agreement;
Residence Hall Payment Plan Worksheet and I (we) agree to and accept all terms listed within its
Agreements.

Guarantor Name: Date:

Guarantor Signature: .
Student Name: Date:

Student Signature: .

SECTION TO BE COMPLETED BY GUARANTOR

Mailing Address:
City: State: Zip:

Email Address:
Driver’s License #: State: Expiration Date:
(Copy of Driver’s License Required)

Employer:
Employment Address:
City: State: Z ip:
Work Phone:

23
 Minor Addendum 1

College of the Redwoods

Department of
Residential Life
Eureka Campus

Contract Addendum:
Minor Students in the Residence Halls
(Minors: Students under the age of 18 years old)

The purpose of this contract addendum is to make certain that all minor students who are
accepted into the Residence Halls at College of the Redwoods have a clear understanding
of the implications of their choice to live in an adult environment. The College is
requiring that the parents/guardians of these minor students also sign this addendum, so
that there will be a shared understanding of how the college views the presence of minor
students in the Residence Halls, and how the staff will approach certain issues, should
they arise. This document must be signed and returned to the Residential Life Office
before the student will be allowed to move into the halls.

First, it is our expectation that both the student and the parent/guardian realize that the
student is moving into a living environment that is designed for adult students.
The staff, therefore, will not be assuming the role of “in loco parentis” for the minor
students who choose to live on the CR campus. Put more plainly, the staff will not serve
as substitute parents to minor residents, nor will they monitor minor students’ behavior or
view their choices differently than they would those of students aged 18 and older.

Secondly, it is our expectation that the student and parent/guardian have had a discussion
of the realities and potential risks of living away from home in an adult environment, and
that they have determined that the student has the maturity to live and function in this
setting. We assume, too, that the student is empowered and expected to make day-to-day
academic and life-style decisions and choices on his/her/their own.

Finally, it is our expectation that the parent/guardian wants and expects the student to
find and use his/her own voice.

From the college’s perspective, these three expectations translate into the following
operational guidelines for the staff working with residents in the halls:

• The staff will expect to hear directly from the student when there is an issue or
concern that needs to be resolved. If the student is sharing information with
his/her/their parent/guardian that the parent/guardian thinks we need to know
about, she/he/they should encourage the student to tell us, not call us to speak
for the student. If the student cannot speak for himself/herself/themself, he/she/
they is probably not mature enough to move into this environment.

• The student will be expected to tell the staff if she/he/they sees or knows of
behavior that violates the Student Code of Conduct or the residence hall
guidelines. If
24
 Minor Addendum 2

the staff doesn’t know about such behavior, they can’t participate in solving
the problem. The college will not let a student out of the contract if she/he/
they has not reported such behaviors to the staff and given them the
opportunity to respond.

• The student will be expected to tell the staff in a timely way if there is
something about the living environment that is not acceptable to him/her. We
will not let a student out of the contract if she/he/they has not reported an issue
to the staff in a timely way and given them the opportunity to respond.

• We will not expect older students to modify their behavior solely because there
are minor students living in the halls. Minor students should expect to be
exposed to legal materials that older students may talk about,
post/watch/download/have in their rooms, and they should expect to be
exposed to activities in which older students are likely to engage.
Please acknowledge your receipt, review, understanding, and acceptance of the
contents of this addendum by printing and signing below.

Parent/Guardian Name: Christine Nelson

Date: 4/10/2024

Student Name: Abytha Newell Abytha Newell

Date:

Received and Filed:

Director, Housing Operations Date

NOTE: If the student is an emancipated minor, the student may sign and submit
this addendum without the signature of a parent/guardian, but a copy of the court
documents that corroborate his/her/their emancipated status must be attached or
already on file with the Residential Life Office.

Updated 3/5/24
25