Department of Community Living

Mid-Year Pull-In Request

Students who wish to be pulled into a room, suite, or apartment for the spring semester must complete the form below. Fields marked with * are required. Forms with incomplete information will not be processed.

Student Information

*First Name:

*Last Name:

*Brandeis Email Address:

*Gender:

*Sage ID #:

*Class year: First-year Sophomore Junior Senior Graduate Student

*I currently live:
On-Campus Off-Campus Abroad Other

If I live on campus, my current housing assignment is:
Quad: 567 South St. Castle Charles River East Massell Mods North Ridgewood Rosenthal Village Ziv

Building (if applicable):

Room #:

Pull-In Assignment Information

Requested Pull-In Assignment:
*Quad: 567 South St. Castle Charles River East Massell Mods North Ridgewood Rosenthal Village Ziv

Building (if applicable):

*Room #:

Please include the names of all residents remaining in the room, suite, or apartment during the spring semester. This form will not be processed without the names and email addresses of all remaining residents. Residents may be contacted to verify the accuracy of this form and obtain consent for a pulled in student.

1. Name:
   Email:
2. Name:
   Email:
3. Name:
   Email:
4. Name:
   Email:
5. Name:
   Email:

*By checking this box, I agree to the following:

• I understand that it is my responsibility to notify my current roommate(s) of my intention to move.
• I understand that requests may only be honored if space is available and this form is submitted by appropriate deadlines. All requests are subject to review and are not guaranteed.
• I understand that the Department of Community Living reserves the right to make changes to room assignments if it deems it necessary.
• I recognize that there may be a change in my housing rate if my requested move is to a different housing type or location.
• I will be required to select a meal plan if the housing area I move to requires one.