Staying for Breaks Form

Staying for Breaks Form
Name*

First NameLast Name
W Number*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
Must be your WNMU Email
Building*
Room Number*
Which break will you be staying for?*

Spring Break 2025
Please select which dates you will be staying for Spring Break 2025.*

Saturday March 8thSunday March 9thMonday March 10thTuesday March 11thWednesday March 12thThursday March 13thFriday March 14thSaturday March 15thAll dates listed
I understand that campus is closed during this break. *
Initial Here
I under that during this time, there are no on-campus dining facilities open and Housing staff are not responsible for providing meals options for me. *
Initial Here
I understand that despite there being no dining facilities open, the Housing policies regarding cooking appliances still apply to me. *
Initial Here
I understand that there will still be Housing staff on campus during these breaks and they are permitted to conduct room checks. *
Initial Here
Signature*

Clear
Should be Empty: