Email: email@example.comFax: (717) 477 - 4040
Student Name: Student ID:
Current Hall: Current Room: Ship Email (required):
I agree to pay the single room rate of 1.5 times the standard room rate.
I understand that by submitting this form, I am responsible for the charges.
I have 48 hours after the approval to cancel this request without any obligation to the charges.
I understand that I may be moved to a vacancy on campus if I cancel my request for a single room
Students will not be billed directly for these charges. Students will receive a returned copy of this form when it is approved via email. Upon approval, payments should be sent to:
Shippensburg UniversityStudent Accounts100 Old Main DriveShippensburg, PA 17257
Students should indicate with their payment that they are paying for the single room charge.
Thank you for your single room request.
If/when a single room becomes available the Housing Office will email
you at your Ship email account.
Yvonne ShoopHousing Office(717) 477-1500