Change of Housing Request Form

Students who desire a room change need to complete the form below. Fields marked with * are required. Forms with incomplete information will not be processed.

*First Name:

*Last Name:

*Brandeis Email Address:

*Gender:

*Sage ID #:

*Class year:

*Cell Phone or Other Phone Number:

Current Housing Assignment:
* Quad: Building (if applicable):

*Room #:

*Desired Change For:

Preferences: Enter your top housing choices. Please include specific names and suites/rooms/locations. While Community Living will work to assign you to housing that meets one of your preferences, there is no guarantee we can accommodate all requests. Please keep in mind that housing is class specific and that availability changes frequently.

 
Quad:
Room Type:
Housing Type:
*Preference 1:
Preference 2:
Preference 3:
Preference 4:

Additional Information: Please provide any additional information regarding your request, such as specific buildings or rooms you would like to live.

*By checking this box, I recognize that there may be a change in the housing rate I will be charged if my requested move is to a different housing type. I will be required to select a meal plan if the housing area I move to requires one.

Please verify that all of the above information is correct. The information will be sent to your current Community Development Coordinator who will contact you to discuss your request.