Request for Late Move Out

* First name * Last name
* Student Number
* Email address
* Location * Bedroom Number
* Requested Move Out Date
* Reason for Late Move Out

The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By submitting this form, you are consenting to the University of Regina Residences using your personal information to contact you about and/or administer your Late Move Out request.