Proxy Statement for Housing Lottery

Students who will not be available during Housing Lottery will need to complete this form and send it to the Office of University Housing by March 7, 2008. Please note that by signing below you agree to accept the assignment selected by your proxy. In order to make a valid request a Contract Acceptance Form and $250 deposit for 2008-2009 must be turned in by the March 7, 2008 deadline.

I, (print full name)__________________________________________, assign the student listed

below to act as my proxy for the purpose of selecting a room for 2008-2009.

I understand that I will be bound by the selection made by my proxy.

Signature: ___________________ Student ID#: _______________    PIN # ____________  Date: ________

I,(print full name) _________________________________, agree to serve as proxy for the

above student for the sole purpose of selecting a room assignment during Housing Lottery.

Signature: __________________ Student ID#: __________ Date: ________