If you have been approved to live off-campus, you have a responsibility to provide the College your off-campus address. Please use this form to notify the assistant director of residence life of your address and phone number.

The housing office needs the information requested at the beginning of the term your housing exemption starts. You may indicate your preference concerning information you want made available to the public. Your address and phone number will be kept in the housing office. Information that is provided in the fall is used for spring also, unless it is changed by you. It is assumed that your information will be given to Hampshire College faculty and staff when requested. It will also be given to students and others unless you indicate otherwise. If you have any questions, please contact the assistant director of residence life, at 559.5543. Thank you for your help.

Name____________________________________________  For term:_______

Off-campus address and phone:

___________________________________________________

____________________________________________________

____________________________________________________

Phone:_______________________________________________

Your address and phone number will be made available upon request unless you indicate below:

 _____ I do not want my address or phone information given to anyone other than faculty or staff.

  _____ Please give my phone number only upon request.

  _____ Please give my address only upon request.

Please return this form to the Director of Housing Operations, Box MH, Hampshire College, Amherst, MA  01002-5001.