Projected Withdrawal Instructions
All residents who know they will not be returning to the University as an enrolled U-M student for Winter Term should submit this Online Projected Withdrawal Notice by November 16th, 2009, if possible. The Community Center Manager in your Residence Hall or the Northwood Residence Live Coordinator will receive and process this on-line form.

Early submission of forms will enable the identification of empty beds for the Winter Term, thereby giving current residents the first choice of the most desirable types of vacancies prior to filling the available spaces with new applicants.

Do NOT fill out this form if you are returning to the University for Winter Term 2010 and wish to request termination of your contract. Currently enrolled students are held financially responsible for their signed contracts. Please follow the regular procedure for contract termination or reassignment if you will continue to be an enrolled U-M student.

Questions
Please direct any questions on this process to the Housing Information Office at 1011 Students Activities Building, 763-3164, housing@umich.edu.

Online Application
Residence Hall/Northwood III Projected Withdrawal Notice
Please complete all fields.

Your Information and Address
First Name (Jane)
Middle Initial (A)
Last Name (Smith)
Permanent Phone: (please enter the phone number of your permanent address as 000-000-0000)
Your email address: (Enter as uniquename@umich.edu)
University of Michigan ID (Enter your 8-digit ID as 00000000)
School/College (Select your School or College from the list)	Art Architecture LSA Education Engineering Nursing Kinesiology Pharmacy Residential College Natural Resources Business Administration Music Please Select
Your Campus Address
Residence Hall/Apartment: (please select your Residence Hall/Apartment Complex from the drop down list)	Your Residence Hall Alice Lloyd Baits I & II Houses Betsy Barbour Bursley Hall Cambridge House Couzens Hall East Quadrangle Fletcher Hall Henderson House Martha Cook Building Mary Markley Hall Mosher-Jordan Hall Helen Newberry House Northwood Apts. South Quadrangle Stockwell Oxford Housing West Quadrangle
House: (leave blank if your Residence Hall is not divided into Houses)
Room# /Apartment and Unit#
Campus Phone:
Please indicate the date you will be vacating University Housing.
Date (Enter as MM/DD/YYYY) (No later than 12/23/2009 at 7:00 pm)
Please indicate why you will be vacating University Housing at the end of Fall Term
Withdrawal From the University (Not enrolling for Winter Term)
Graduation (Not enrolling for Winter Term)
Marriage Prior to 01/12/2009 (Documentation to be submitted to HIO.)
University Sponsored Co-Op Program (Please include the name of your program below)
Program:
Term/Year Abroad (Please include the name of your program below)
Program:
By submitting this Online Projected Withdrawal Application, I waive all priority for my present room assignment. I realize that if my contract is not terminated because of the above stated reason(s), I will be reassigned to another space in the Residence Halls and held responsible for the new space assigned to me.
Also note that this Online Projected Withdrawal Application does not automatically withdraw you from your school or college. You must complete academic unit procedures if you will not be attending classes next term.
When you move out of a residence hall, housing staff will forward first class mail for 30 days for those students who complete the Mail Forwarding Request form.