Petition Waiver Form – Residential Life

Please review the petition requirements before submitting this form.

Before You Proceed
As noted in the petition requirements, you should NOT submit this form unless you have received indication from Financial Aid and/or Dining Services that you are eligible to do so and a good candidate for a successful petition. The threshold for approval is high. Incomplete petitions will not be considered.
Student Information
Name * Required
First Last
Student ID Number * Required
Current Housing Assignment * Required
Include residence hall/house and room number. If you do not have a housing assignment, type N/A.
Email * Required
K College email only
Phone * Required
Class Standing * Required
Permanent Address
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Waiver Information
I am petitioning to waive: * Required
- Board Plan Only
- Housing Only
- Housing and Board Plan
Reasoning for the petition: * Required
- Financial Hardship
- Health
Term: * Required
Select all that apply
- Fall Quarter
- Winter Quarter
- Spring Quarter
Statement of Understanding
Release of Confidential Information * Required
By checking the box below, you give permission for College offices or personnel (e.g. Counseling or Heath Centers, Financial Aid, Residential Life) to release pertinent confidential information to the Petition Committee in consideration of your petition.
- I agree

Before You Proceed