Accidental Private Interest Form

Accidental Private Interest Form
Accidental Private rooms are periodically offered to students whose current roommate
has checked out, leaving an unoccupied space in the room. Typically these unoccupied
spaces are filled by incoming students or those who have completed a Room Change
Request form during the room change period. Room changes and new assignments
supercede the offering of Accidental Privates.
By completing and signing this form you are expressing your interest to retain your
current room as an accidental private in the event your roommate moves out and you are
not assigned a new roommate. Upon completion of this form your name will be placed
on an interest list and your room will automatically be converted to an accidental private
if available. Upon conversion of your room to an accidental private your student
account will be charged $725. You will be notified by email and it is your
responsibility to provide the Housing Office with your current email address.
Yes, I am requesting to retain my current room as an accidental private:
Name
Current Room
Email
Yes, I understand that my student account will be charged $725 in addition
to my current room and board charges and I agree to pay this amount in full.
When you sign this form you are agreeing to the Terms and Conditions of the License Agreement, to pay all room and board fees
when due, to abide by all rules and regulations and policies as outlined in the Student Handbook, Residence Hall Handbook, and
supporting documents covering room and board accommodations at the University of Nevada, Reno. You must be enrolled in a
minimum of 12 credits per term. You further authorize the University to charge your student account for an Accidental Private room
as outlined above and in the Rates Brochure.
Signature
Parent/Guardian Signature (if under 18)
Date
Date