Dorm Room Check-out Form

Student Name – Individual Checking Out*

First Last

Student Email*

Dorm Leader's Name – Individual Inspecting Room*

First Last

Dorm Room Number*

Check Out Requirements

Window Cleaning*

Please attach a picture of the cleaned window(s)*

Drop files here or

Max. file size: 50 MB.

Desk, Shelving and Closet*

All surfaces washed and dusted (all shelves including top of closet and bookshelf)
No stains on desk or shelves

Please attach a picture of the cleaned desks and closets*

Drop files here or

Max. file size: 50 MB.

Beds & Dresser*

Please attach a picture of the beds and dresser*

Drop files here or

Max. file size: 50 MB.

Additional Cleaning*

Please attach a picture of the entire room*

Drop files here or

Max. file size: 50 MB.

Damage, Missing Items, Personal Items left*

Items Missing (mattress, bed frame, dresser, blinds, clothing rod, etc.)
Items Damaged (door, carpet, window, blinds, bed frame, dresser drawers, smoke detector, etc.)
Personal items not completely removed (trash, chairs, clothing, furniture, etc.)
Nothing damaged, missing or left behind

Please leave a description / explanation for any damage, missing items or personal belongings left behind

Please attach a picture of any damage, missing items or personal belongings left behind

Drop files here or

Max. file size: 50 MB.

Does the student qualify for their $100 deposit?*

Yes – Full $100 room deposit to be credited
No – Missed Deadline – Room is cleaned with no damage or missing items but did not move out by the deadline
No – Room not cleaned to standard – but nothing damaged or missing
No – Fines to be assessed; missing or damaged items, personal belongings left