Spring Break Online Break-Stay Request Form

Residence Halls close on Saturday, March 9th at noon and reopen on Sunday, March 17th at 10am. 
Belmont Community Housing, Campbell Hall, Salice Conley Hall and Walsh Hall remain open for Spring Break.
If you not live in one of these buildings, you must find a host in one of them to stay with.

Students who would like to make arrangements to stay during the break, must fill out this online breakstay form no later than 11:59pm on March 4, 2013. They must be approved by their RD to stay. Hosts must be present at all times to accompany their guests while in the building.

• All residence halls close for spring break except for Walsh Hall, Campbell Hall, Salice Conley Hall and Belmont Community Housing which does not close at all. Residents who need to stay during the break, must make arrangements to stay with students in Walsh Hall, Campbell Hall, Salice Conley Hall or Belmont Community Housing. There are no early arrivals permitted!
• Residents who have not been approved for break stay must leave the residence halls by the 12pm deadline
• Any resident who stays in the residence hall after the closing deadline and who has not received RD permission to do so will be charged $25.00/hour that they stay
• All residence halls besides Walsh Hall, Campbell Hall, Salice Conley Hall and Belmont Community Housing close on Saturday, March 9th at 12pm.
• All other residence halls reopen on Sunday, March 17th at 10am. Locks to the buildings will be changed during the break. Please make your travel arrangements accordingly!

* All fields in red are required

STUDENT REQUESTING BREAKSTAY PLEASE FILL OUT THIS PORTION

First Name:
Last Name:
Fordham ID number:	A - - (enter numbers only)
Cell Phone Number:	- -
Email Address:
Hall:	Alumni Court South Campbell Hall Finlay Hall Loschert Hall Martyrs' Court Jogues Martyrs' Court Goupil Martyrs' Court LaLande OHare Hall Queen's Court Bishops Queen's Court Roberts Queen's Court Johns Salice Conley Hall Tierney Hall Walsh Hall Arthur 1 Arthur 2 Hughes House Terra House Nova House
APARTMENT Number/ Letter:
ROOM Number/ Letter:
Requested START Date of Stay	Select Date
Requested END Date of Stay	Select Date
Reason for request to stay over break:
Student Organization Campus Ministry Work/Internship Athletics	Family Issues Travel Issues Other
If OTHER than please explain below:
Emergency Contact Name:
Emergency Contact Phone:	- -
Special requests or comments your RD needs to know before reviewing your request:

Please choose the below statement that applies to you:
I live in Walsh Hall, Campbell Hall, Salice Conley Hall and Belmont Community Housing and do not need a host.

I do not live in Walsh Hall, Campbell Hall, Salice Conley Hall and Belmont Community Housing and need a host.

""

"If you do not live in either Walsh Hall or BCH, you must find a host from either of those buildings to stay with for the days you wish to stay on campus during break and they (not you) must fill out the following portion of this form. We will not accept any requests that do not have a completed Host portion of their application."

THE STUDENT HOSTING THE ABOVE STUDENT MUST FILL OUT THIS PORTION

First Name:
Last Name:
Fordham ID number:	A - - (enter numbers only)
Cell Phone Number:	- -
Email Address:
Hall:	Arthur House Campbell Hall Salice Conley Hall Terra Nova House Walsh Hall
APARTMENT Number/ Letter:
ROOM Number/ Letter:
Emergency Contact Name:
Emergency Contact Phone:	- -
Please read and initial:	I understand that by entering my initials below, I take full responsibility for the actions of the student I am choosing to host for the period of time they spend in my care:
Special requests or comments your RD needs to know before reviewing your request: