Name   Student ID    
Email Phone  
Building:                Room:
Reason for Break Occupancy
The residence halls are only open to students who meet one or more of the following criteria.  

If Other, please explain:
Applicable Charges
Dates you will be occupying your room over break:
Number of overnights:
Break Guidelines and Expectations
  • No visitors are allowed in the residence halls except for those students who also have been approved for break housing. Gender-specific visitation rules and all campus policies still apply over breaks! Contact your hall director if you have any questions.
  • Meals are not provided by BCU over breaks.
By checking this box, you agree that you have read and understood the above contract and will adhere to the rules contained within the Briar Cliff University handbook and housing contract as well as the above listed break housing policies.

Copyright 2012 by Briar Cliff University