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This form is intended to appeal permission to return and live in the Residential Community under special circumstances conditions.  All requests must be in three days in advance of your desired return to campus.  These requests will be assessed based on need (please see the reasons below). 

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* 1. First Name 

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* 2. Last Name 

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* 3. Alfred State Email Address

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* 4. Building Name

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* 5. Room Number

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* 6. Please state your reason for needing to return to campus during the period of limited staff and services?

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* 7. Requested date to return to campus

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Time

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* 8. By checking the following box, I further acknowledge awareness of dramatically reduced services, facilities, and amenities available.   I understand all events are canceled though April 30th and that none will be added. I am aware that there will be one dining option with limited to grab-and-go and I will have no fitness center or gym/pool access.  I understand my room assignment will be changed to accomplish the College requirements of social distancing and to avoid student housing placement in buildings that are unfit for quarantine operations.  I understand that I may have my movement or access restricted between buildings, including both time-based and location-based movements.  I understand I am allowed no guests in my room, will have no shared kitchen access, and no access to a floor/lounge microwave.  I recognize that failure to comply with the changing requirements may result in my removal from the facility if my non-compliance is believed to pose a threat to the public health goals of the College

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