Application Cancellation

By filling out this form you, are requesting that your housing application be cancelled, and that any remaining Housing Deposit monies be refunded.  

I understand that the refund will be as follows:

Termination of this agreement prior to occupancy will result in the following refunds of the deposit, less the $100.00 application fee. In all cases, it is the student's responsibility to inform the Office of Residence Life and Housing that they are canceling their assignment. If the student does not cancel their agreement before the start of the semester, they will be responsible for two weeks worth of payment for their assigned room type.
  1. Prior to May 31st (December 1st for Spring) there will be a full refund of the $200 security deposit and $300 housing prepayment (if applicable).
  2. After May 31st (January 1st for Spring) there will be no refund, even if the application is received after this date.  If the student fails to notify the Office of Residence Life and Housing before the first day of classes that they are not moving into their assigned room, they will be responsible for two weeks worth of housing charges for their assigned room type. 
*Last Name
*First Name
*Student ID
*Email Address
*Reason for Cancellation
*Semester of Application
*Agreement

There is a non-refundable $100.00 application fee.  All refunds, depending on the above termination guidelines, will be placed on your UCCS student account.  If you have not registered for classes, or do not have an outstanding balance, a refund will be mailed to your address of record with the University after approximately 30 days.
* denotes required field