Housing Exemption Form

Exemption from the Freshman Residency Requirement

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Freshmen (defined as students who have compiled fewer than 30 hours of college credit) and International students are required to live in college housing for at least two semesters. Exempted from this policy are students who have reached their twenty-first birthday prior to the first day of classes; veterans of at least two years’ active military service; married students; students who commute to school daily from their permanent, legal residence of their parents (within a 60 mile radius of campus), and international students living with a host family.
Last Name*
Middle Initial*
First Name*
NIACC ID Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone Number
Cell Phone Number
Reason for requesting exemption (Check all that apply)*
- I have been enrolled fulltime at a postsecondary institution for two semesters and have completed 30 or more college credits (excluding high school enrollment and summer terms)
- I am married and live with my spouse
- I am a single parent with custody of my child(ren)
- I am a veteran of two years’ active military service
- I am or will be 21 years old prior to the first day of classes
- I will commute daily from the permanent home of my parents/guardian
- I have a serious medical condition that cannot be accommodated in college housing
- Other
(Other) Reason for requesting exemption*
Birthdate*
Month
Day
Year
Student agreement*
- By checking this box, I agree that the above information provided is accurate
Any student who wishes to appeal a Freshman Residency exemption decision may do so. Appeals must be submitted in writing with any supporting documentation. The student should present the appeal to the Vice President for Student Services.

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Housing Exemption Form