SDSM&T Residence Life
Vacation Housing
Semester Break 2009
Application and Contract—must be completed and returned to Residence Life by 7:00am December 14, 2009.

Name
  (last) (first) (middle name)
Email

Student ID   Phone Number
Residence Hall   Room Number

Reason for Needing Vacation Housing (please check one, provide clarification when requested):
 
I am required to stay on campus for school related reasons.
 
Work/Project Department

Supervisor/Instructor/Coach Signature _____________________________________________
I am unable to travel to my home. Location (city, state, country)
I work in the Rapid City area. Business
Other (will need approval from the Director of Residence Life)
 
Residence Life Signature _____________________________________________


All students contracted with Residence Life to stay on-campus for any duration between noon December 19, 2009 – 8:00am January 10, 2010 will be charged $9.25 per night (a maximum of $175 for the entire stay).

Students that are required to be on-campus for school related reasons (as noted above) will not be charged if their application is submitted in a timely manner with the appropriate signatures.

Keys will be issued during business hours from the Residence Life Office in Surbeck Center (7:30 a.m. – 4:30 p.m. Monday – Friday). Other arrangements must be made in advance.

Keys will be issued and charges will be assessed based on the dates listed below indicating the duration of your stay—any changes to these dates and associated charges are subject to approval of the Residence Life Office.

Applications submitted after 7:00am December 14 will be assessed a $10 late application charge and an additional $1 per day for each day following.  Immediate access for late applications is NOT guaranteed.

Beginning Date Ending Date
Total number of nights x $9.25 = (amount to be charged, maximum of $175)

Please read carefully and select the checkbox below to confirm the accuracy and your understanding of the rules and regulations.

In submitting this form, I am certifying the accuracy of all information provided. I am aware of and understand that I must abide by the rules and regulations of SDSM&T Residence Life as outlined by the SD Board of Regents and the university. I understand I will be charged a daily rate for the duration of my stay and payment is due at the SDSM&T Cashier’s Office based on the schedule agreed upon. Furthermore, I understand that failure to return the vacation-housing key by 3:00 p.m. on January 15, 2010 will result in a non-refundable $25 lost key fine.

If vacation-housing charges are a financial hardship, please meet with Reeny before December 14, 2009 to discuss your situation.

South Dakota School of Mines and Technology does not discriminate on the basis of race, color, national origin,
military status, sex, religion, age, sexual orientation, political preference or disability in employment or the provision of service.