University Dining Meal Plan Declaration Form
Declare your university dining meal plan selection and provide eligibility details for the current academic term.
Student Full Name
*
First Name
Last Name
University Email Address
*
example@example.com
Student ID Number
*
Academic Term/Semester
*
Please Select
Fall 2026
Spring 2027
Summer 2027
Other
Campus/Residence Hall or Dining Location
*
Please Select
Main Campus
North Campus
South Campus
East Hall
West Hall
Dining Center A
Dining Center B
Other
Meal Plan Selection
*
Unlimited Plan
19 Meals/Week
14 Meals/Week
10 Meals/Week
Block Plan
Other
Meal Plan Status / Eligibility Declaration
*
I am eligible for the selected meal plan
I am requesting an exception or change
Are you required to have a meal plan?
*
Yes
No
Unsure
Dietary Accommodation Note (if needed)
Submit Declaration
Should be Empty: