* 1. Please Indicate your name and campus address:

* 2. Please indicate the date and time you are completing your checkout:

As I leave for the semester break on or before Friday, December 21st, 2012 @ 5pm, I acknowledge that it is my responsibility to: 

1. Clean, defrost, unplug, and
prop the door open on my microfridge or
refrigerator unit
2. Open my curtains and/or blinds (close windows)
3. Clean my room and dispose of
trash properly
4. Take valuables, fish, and plants
5. Turn off my lights and lock
my door

My room must be left clean and in good condition to avoid any additional charges being assessed to my Student Account.  I further understand that my room will be inspected over the semester break by my Residence Hall Staff.  Lastly, I understand that by performing an Electronic Check-out, I waive my right to appeal any damage charges that are assessed on my Student Account. By clicking "SUBMIT" below, I am agreeing to the aforementioned information.